Howes x's List: Tests and Diagnosis

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  • Physical exam. Your doctor will look for physical signs of  leukemia, such as pale skin from anemia and swelling of your lymph nodes, liver  and spleen.  
  • Blood tests. By looking at a sample of your blood, your  doctor can determine if you have abnormal levels of white blood cells or  platelets — which may suggest leukemia.  
  • Bone marrow test. Your doctor may recommend a procedure to  remove a sample of bone marrow from your hipbone. The bone marrow is removed  using a long, thin needle. The sample is sent to a laboratory to look for  leukemia cells. Specialized tests of your leukemia cells may reveal certain  characteristics that are used to determine your treatment options.

• • Biological therapy. Biological therapy works by helping  your immune system recognize and attack leukemia cells.  
  • Targeted therapy. Targeted therapy uses drugs that attack  specific vulnerabilities within your cancer cells. For example, the drug  imatinib (Gleevec) stops the action of a protein within the leukemia cells of  people with chronic myelogenous leukemia. This can help control the disease.  
  • Radiation therapy. Radiation therapy uses X-rays or other  high-energy beams to damage leukemia cells and stop their growth. During  radiation therapy, you lie on a table while a large machine moves around you,  directing the radiation to precise points on your body. You may receive  radiation in one specific area of your body where there is a collection of  leukemia cells, or you may receive radiation over your whole body.  
  • Stem cell transplant. A stem cell transplant is a procedure  to replace your diseased bone marrow with healthy bone marrow. Before a stem  cell transplant, you receive high doses of chemotherapy or radiation therapy to  destroy your diseased bone marrow. Then you receive an infusion of blood-forming  stem cells that help to rebuild your bone marrow. You may receive stem cells  from a donor, or in some cases you may be able to use your own stem cells. A  stem cell transplant is very similar to a bone marrow transplant.

• leukemia cells travel through the body. The symptoms of leukemia depend on the  number of leukemia cells and where these cells collect in the body.
• chronic leukemia may not have symptoms. The doctor may find the disease during a  routine blood test.
• People with acute leukemia usually go to their doctor because they feel sick. If  the brain is affected, they may have headaches, vomiting, confusion, loss of  muscle control, or seizures. Leukemia also can affect other parts of the body  such as the digestive tract, kidneys, lungs, heart, or testes.

• Common symptoms of chronic or acute leukemia may include:

   
   
  • Swollen lymph nodes that usually don't hurt (especially lymph nodes in the  neck or armpit)
    
     
  • Fevers or night sweats
    
     
  • Frequent infections
    
     
  • Feeling weak or tired
    
     
  • Bleeding and bruising easily (bleeding gums, purplish patches in the skin,  or tiny red spots under the skin)
    
     
  • Swelling or discomfort in the abdomen (from a swollen spleen or  liver)
    
     
  • Weight loss for no known  reason
    
     
  • Pain in the bones or joints
• Most often, these symptoms are not due to cancer. An infection or other health  problems may also cause these symptoms.

• Diagnosis
• • Physical exam: Your doctor checks for swollen lymph nodes, spleen, or  liver.
    
     
  • Blood tests: The lab does a complete blood count to check  the number of white blood cells, red blood cells, and platelets. Leukemia causes  a very high level of white blood cells. It may also cause low levels of  platelets and hemoglobin,  which is found inside red blood cells.
    
     
  • Biopsy: Your doctor removes tissue to look for cancer cells. A biopsy  is the only sure way to know whether leukemia cells are in your bone marrow.  Before the sample is taken, local anesthesia is used to numb the area. This  helps reduce the pain. Your doctor removes some bone marrow from your hipbone or  another large bone. A pathologist uses a microscope to check the tissue for  leukemia cells.
    
    

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