Virginia Commonwealth University

VCU Massey Cancer Center

Diagnosis and symptoms

How is leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for leukemia may include one of the following methods:

  • 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.
  • Complete blood count – a measurement of size, number and maturity of different blood cells in a specific volume of blood.
  • Additional blood tests – may include blood chemistries, evaluation of liver and kidney functions, and genetic studies.
  • Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.
  • Magnetic resonance imaging – a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body.
  • X-ray – a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film.
  • Ultrasound (also called sonography) – a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. Ultrasounds are used to view internal organs as they function and to assess blood flow through various vessels.
  • Lymph node biopsy.
  • Spinal tap/lumbar puncture – a special needle is placed into the lower back into the spinal canal (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 can be removed and sent for testing to determine if there is an infection or other problems. Cerebral spinal fluid is the fluid that bathes your child’s brain and spinal cord.

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What are the various stages of leukemia treatment?

There are various stages in the treatment of leukemia, including the following:

  • Induction – a combination of chemotherapy and/or radiation and medications given to stop the process of abnormal cells being made in the bone marrow. Remission is the goal in this stage of treatment. Remission means the leukemia cells are no longer being made. This phase may last approximately one month and can be repeated if the goal is not achieved.
  • Intensification – continued treatment even though leukemia cells may not be visible. The leukemia cells may not be visible in a blood test or bone marrow examination, but it is possible that the cells are still present in the body.
  • Maintenance – the stage that maintains leukemia-free bone marrow by continuing less intense chemotherapy for a longer duration. This phase can last months to several years. Regular visits to your child’s physician are required in order to determine response to treatment, detect any recurrent disease and manage any side effects of the treatment.
  • Relapse – may occur even with aggressive therapy. Relapse is when the bone marrow begins making abnormal cells again. Relapse can occur during any of the stages of treatment, or may occur months or years after treatment has ended.