How is it assessed?
Leukaemia is usually suspected from blood tests, particularly the full blood count (FBC).
Further tests are done to
confirm and type the leukaemia. These tests include -:
- Further blood tests including liver function tests (LFT) and urea & electrolytes (U+E) to check kidney and liver function.
- Bone marrow aspiration /biopsy.
- Further tests will be carried out on the blood or bone marrow to find out what type of leukaemia is present – this may be called ‘immunophenotyping’ in the medical evidence.
- Chromosomal analysis (cytogenetics) and molecular characterisation (see MRD below) of the cells will also be undertaken.
- Lumbar puncture to see if the brain or spinal cord is affected by leukaemia.
- Chest X-ray.
- Ultrasound scan of the abdomen to look at possible kidney involvement or abnormalities. An enlarged spleen, liver and lymph nodes are commonly seen.
- Minimal residual disease (MRD) – if the cells can be characterised at the molecular level, a very sensitive molecular technique can be used to look for (MRD) at different time points during therapy. If minimal residual disease is not detected after induction, patients do very well with only one intensification block and then maintenance therapy. If MRD is detected at this time point, then more intensive therapy is given before maintenance is started.
