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Tests and diagnosis
By Mayo Clinic staff
Blood tests
Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to:
- Count the number of cells in a blood sample. A complete blood count may be used to count the number of lymphocytes in a blood sample. A high number of B cells, one type of lymphocyte, may indicate chronic lymphocytic leukemia.
- Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine whether an increased number of lymphocytes is due to chronic lymphocytic leukemia, a different blood disorder or your body's reaction to another process, such as infection. If chronic lymphocytic leukemia is present, flow cytometry may also help analyze the leukemia cells for characteristics that help predict how aggressive the cells are.
- Analyze lymphocytes for genetic abnormalities. A test called fluorescence in situ hybridization (FISH) examines the chromosomes inside the abnormal lymphocytes to look for abnormalities. Doctors sometimes use this information to determine your prognosis and help choose a treatment.
Other tests
In some cases your doctor may order additional tests and procedures to aid in diagnosis, such as:
- Bone marrow biopsy and aspiration
- Computerized tomography
Staging
Once a diagnosis is confirmed, your doctor determines the extent (stage) of your chronic lymphocytic leukemia. Two different staging systems are used. Each assigns a stage — early, intermediate or advanced — that indicates the progression of a person's chronic lymphocytic leukemia. These levels are used to determine your treatment options.
In general, people with early-stage disease don't require immediate treatment. Those with intermediate-stage disease and advanced-stage disease may be given the option to begin treatment right away.
- Kipps TJ. Chronic lymphocytic leukemia and related diseases. In: Lichtman MA, et al. Williams Hematology. 8th ed. New York, N.Y.: McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=69. Accessed Sept. 16, 2010.
- Grever MR, et al. Chronic lymphoid leukemias. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2007:2293.
- Elphee EE. Caring for patients with chronic lymphocytic leukemia. Clinical Journal of Oncology Nursing. 2008;12:417.
- Chronic lymphocytic leukemia treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/CLL/patient/allpages. Accessed Sept. 15, 2010.
- Arzerra (prescribing information). Research Park Triangle, N.C.: GlaxoSmithKline; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125326lbl.pdf. Accessed Sept. 15, 2010.
- Cancer-related fatigue. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/fatigue.pdf. Accessed Sept. 15, 2010.
- Shanafelt TD, et al. Phase I trial of daily oral polyphenon E in patients with asymptomatic Rai stage 0 to II chronic lymphocytic leukemia. Journal of Clinical Oncology. 2009;27:3808.
- Green tea. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Sept. 24, 2010.
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