How is Leukemia Diagnosed?

Diagnosis

Leukemia can be challenging to diagnose since it does not always present symptoms until the disease has progressed. The cancer is often discovered during routine blood work and may go unnoticed for months or years. If a patient's blood test reveals elevated abnormal blood cell counts, this could indicate a possible blood disorder.

  • Blood tests - Your doctor will order additional blood tests that check for abnormal levels of red or white blood cells or platelets in your blood or bone marrow
  • Physical exam - During a physical exam, your doctor will check for physical signs of leukemia, including pale skin due to anemia, swollen lymph nodes, and enlarged liver or spleen
  • Bone marrow test - Your doctor may suggest a bone marrow test be done. During this, a doctor inserts a thin needle into your hipbone and collects a small sample of bone marrow. The sample is sent to a laboratory to be examined for leukemia cells.
  • Spinal tap - A small amount of cerebrospinal fluid is taken from your spine using a thin needle. A pathologist will examine the fluid under a microscope to look for infection, cancer cells, or other problems.
  • Cytogenetic - Looks for chromosomal changes in your cells
  • Immunohistochemistry - Uses antibodies to distinguish types of cancer cells
  • Flow cytometry - Uses a laser beam to look at proteins on cells' surfaces, and
  • Molecular genetic – A test to determine cancer cells' specific traits

How is Leukemia Treated?

Treatments

There are four main subtypes of leukemia based on whether they are considered myeloid or lymphocytic and acute or chronic. Each type is treated according to its specific characteristics.

The most common treatments for leukemia are:

  • Chemotherapy is often the initial treatment for leukemia. Chemotherapy treatment for leukemia usually includes a combination of drugs that target and destroy leukemia cells. These treatments can come in pill form, or they may be administered intravenously.
  • Targeted therapy uses drugs to detect abnormalities within cancer cells. These drugs block the abnormalities, causing the cancer cells to die. Your doctor will determine whether your type of leukemia will react positively to this type of therapy.
  • Radiation therapy also called radiotherapy or irradiation, uses high-energy X-rays to destroy the DNA within a cell. This prevents the cells from growing and reproducing. Radiation may target one specific area where leukemia cells are concentrated. The radiation may also be used throughout your entire body. Radiation therapy sometimes precedes a bone marrow transplant.
  • Bone marrow transplant is also referred to as a stem cell transplant. These stem cells can come from either a donor or a person's own stem cells. These healthy stem cells replace the damaged bone marrow. Ultimately, the healthy cells, which do not contain leukemia, regenerate into healthy bone marrow.
  • Chimeric antigen receptor (CAR)-T cell therapy creates immune cells from the body's own germ-fighting T-cells to fight leukemia. These engineered cells are then infused back into the patient.
  • Immunotherapy uses a person's immune system to fight disease. Cancer cells produce proteins that "camouflage" them from the immune system cells. Immunotherapy interferes with this process by exposing and destroying cancer cells.
  • Clinical trials may involve physicians and scientists pursuing promising new therapies for fighting cancer. NewYork-Presbyterian offers many clinical trials for cancer.

FAQs

FAQs

The first signs of leukemia may include fever or chills, excessive fatigue, weakness, and frequent infections.

Each type of leukemia is different; however, the most common leukemia, acute myeloid leukemia (AML), usually affects older adults. Therefore, most deaths occur between 65 to 84 years old.

Your doctor can determine from a blood test whether you have abnormal levels of red or white blood cells or platelets. This is a possible sign of leukemia.

Get Care

Trust NewYork-Presbyterian for Leukemia Treatment

NewYork-Presbyterian doctors and cancer care specialists assess your diagnosis and overall health to determine a care plan that’s right for you. We consider your symptoms and when leukemia treatment should begin. Our team will explain all of your treatment options and allow you time to consider every option.