How Is Acute Lymphocytic Leukemia Diagnosed?

This content has been reviewed and approved by

Hagop M. Kantarjian, MD
Chairman & Professor, Leukemia Department
MD Anderson Cancer Center
University of Texas

In addition to a complete medical history and physical examination, diagnostic procedures for acute lymphocytic leukemia (ALL) may include the following:

• Additional blood tests and other evaluation procedures
• Bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells. It is also used to do a cytogenetic analysis to determine if the leukemia cells have chromosomal abnormalities.

These may help in defining prognosis—deciding whether the disease can be cured with chemotherapy alone or better with an allogeneic stem cell transplant once in remission. It also may help know whether additional specific treatments are needed; for example, adding Gleevec^® (imatinib mesylate) to chemotherapy if the Philadelphia chromosome abnormality is present (Ph-positive ALL).

• Spinal tap/lumbar puncture - a special needle is placed in the lower back into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.