You’ll have a set of tests to confirm whether you have leukaemia or not. It can be hard to understand how doctors know you have leukaemia, when there’s often nothing like a lump you can see, as you might get with other cancers.
Your doctors diagnose leukaemia by looking at your blood, your bone marrow and your genes. At any time, you can ask your healthcare team to tell you why you’re having a certain test and what the results mean.
Sometimes it can take a few weeks before you get your diagnosis. You may feel anxious whilst waiting for your test results, but it’s very important that your doctor takes this time to understand your illness, so that you have the right treatment.
Many patients say that it helps to keep themselves occupied; talk to family and friends, or other people who’ve been through the same thing.
Here are some of the common tests which people have to diagnose leukaemia. You might also have tests to help give doctors more information about the type of leukaemia you have.
> Choose a type of leukaemia from the list to find out more information about the tests you’ll have for a specific type of leukaemia.
Full blood count
A full blood count (FBC) measures the number of each type of cell in the blood: red cells, white cells and platelets. You might be sent for this test by your GP as part of a routine check-up. Other patients might have one when they’re in hospital for something else.
If your FBC shows that you might have leukaemia, you’ll need to go to hospital for more tests. If you’re diagnosed with leukaemia, you’ll have regular FBCs to monitor your condition.
A blood film is taken from a sample of your blood, which your doctor or hospital team use to look at your blood cells under a microscope. This allows them to see if you have any leukaemia cells in your blood.
Bone marrow aspirate and trephine
In most cases, your doctor will also take a bone marrow sample to see how your blood is working inside your bone marrow. Bone marrow tests provide information about the structure of the marrow and the number and distribution of the different blood cell types – and cancer cells, if present.
Immunophenotyping and cytogenetics
Sometimes you might have genetic tests, but not everyone has them. These tests are called immunophenotyping and cytogenetics. This genetic information helps your healthcare team decide on suitable treatment options, which they’ll discuss with you.
Several lab tests are done on your blood and bone marrow samples that you’ve given. The hospital team will look at the cells under a microscope. They’ll test whether the cells are leukaemia cells by a technique called immunophenotyping, which counts the number of leukaemia cells and determines the type of cells these leukaemia cells are – this shows what type of leukaemia you have.
Leukaemia is caused by genetic errors. Sometimes this happens on a greater scale, which is easy to see under the microscope. Genes are arranged into structures called chromosomes. We have 46 chromosomes, which can sometimes be broken or rearranged. The hospital team will look to see if this has happened. The study of this is called cytogenetics.
General health tests and infection screening
When you’re diagnosed with leukaemia, you’ll have a general health assessment. This will help your healthcare team to assess how you’re likely to cope with side effects from treatment. You’ll have a range of tests to check your general health, including things like your heart, liver and kidney function, and infection screening for HIV and hepatitis.
Remember: you might not have all of these tests – your doctor will talk to you about which tests you’ll need to have. For more information on the tests you’ll have to diagnose a specific type of leukaemia, choose a type from the list .