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Further tests for ALL

This page has information on further tests you may have if your blood and bone marrow tests show you have acute lymphoblastic leukaemia. There is information on

 

A quick guide to what's on this page

Further tests for acute lymphoblastic leukaemia

If test results show you have acute lymphoblastic leukaemia (ALL), you will have further tests.

Blood and bone marrow tests

You will probably have more blood tests. You will have more bone marrow tests at various times throughout your treatment and follow up care. Bone marrow tests can help to diagnose the type of leukaemia, show how the leukaemia is responding to treatment, and check for leukaemia cells after you've finished treatment.

Scans

You may have a CT, MRI or ultrasound scan. The doctor may use the scans to check whether your lymph nodes or spleen are enlarged or if there are abnormalities in other body organs.

Tissue typing

You will have this done if your doctor thinks that a donor bone marrow transplant may be a possible treatment for you. Tissue typing is a set of blood tests that show how closely a possible bone marrow donor’s tissue matches your own.

Finding leukaemia cells left behind after treatment

Minimal residual disease or MRD means that a small number of leukaemia cells have been left behind after treatment. One type of test for MRD looks for genetic changes in the cells. Another checks for certain proteins made by leukaemia cells.

CR PDF Icon You can view and print the quick guides for all the pages in the diagnosing ALL section.
 

 

At the hospital

If your blood test results suggest leukaemia, your GP will immediately refer you to a specialist at the nearest suitable hospital. You will have more tests, such as those listed below.

 

Blood and bone marrow tests

You will probably have more blood tests. If your doctor thinks you have an infection, you will have blood taken for blood culture tests. These tests can show which type of infection is present and which type of antibiotic is likely to work best. You will also have blood taken to check your kidneys and liver are working properly.

You will have more bone marrow tests at various times throughout your treatment and follow up care. Looking at your bone marrow can help to

  • Diagnose the correct type of leukaemia in the first place
  • Show how the leukaemia is responding to treatment
  • Check for leukaemia cells after you've finished treatment

Checking for leukaemia cells after your treatment is over is called testing for minimal residual disease (MRD). 

 

CT scan

A CT scan is a type of X-ray that takes pictures of your body from different angles. A computer linked to the X-ray machine creates a detailed picture of the inside of your body. A CT scan can show enlarged lymph nodes or abnormalities in body organs. 

 

MRI scan

An MRI scan uses radio waves and strong magnets to give a detailed picture of the inside of your body. An MRI scan can show the soft tissues of the body more clearly than a CT scan. 

 

Ultrasound scan

This test uses high frequency sound waves to create a picture of part of your body. You may have an ultrasound scan to see if there is leukaemia in your spleen or testicles (in men). 

 

Tissue typing

You will have this done if your doctor thinks that bone marrow transplant may be a possible treatment for you. Tissue typing is a special blood test that shows how closely a possible bone marrow donor’s tissue matches your own. Your white blood cells have proteins called HLA markers on their surface. HLA stands for human leucocyte antigen. If you and the bone marrow donor have very similar HLA markers, there is less chance that your immune system will reject their marrow.

More detailed information about these tests can be found in the cancer tests section.

 

Finding leukaemia cells after treatment

Often after chemotherapy for leukaemia, the disease appears to have gone. No leukaemia cells can be seen in your blood and bone marrow samples and your doctor will say you are in remission. But leukaemia cells can be left behind (which is why you may have to go on to have a transplant). Minimal residual disease (MRD) means testing to see whether small numbers of leukaemia cells have been left behind.

There are two techniques for finding MRD. One type, called polymerase chain reaction (PCR) looks for genetic changes in cells. It can find one leukaemia cell among a million normal cells. The other test is called immunophenotyping. It tests for proteins made by leukaemia cells. So these tests can help to show how well your chemotherapy has worked and whether you are likely to have a relapse. Relapse is when the leukaemia comes back.

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Updated: 5 May 2015