Further tests for chronic lymphocytic leukaemia (CLL) | Cancer Research UK
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Further tests for chronic lymphocytic leukaemia (CLL)

Men and women discussing chronic lymphocytic leukaemia

This page tells you about the tests you may have if you have been diagnosed with chronic lymphocytic leukaemia. There is information about

 

A quick guide to what's on this page

Further tests for chronic lymphocytic leukaemia (CLL)

If tests show you have CLL, your haematologist may ask for you to have some more tests. 

A bone marrow test looks at the cells in your bone marrow. The doctor uses a thin needle to draw out some of the liquid bone marrow from your hipbone. The cells are looked at under a microscope in the laboratory.

Your haematologist may order a laboratory test to look for abnormalities in the leukaemia cell genes. Doctors use this test to help them work out which treatment people each person with CLL needs.

If a bone marrow or stem cell transplant is a possible treatment for you, you may have a blood test for tissue typing.

If you have not already had one you may have a CT scan. A CT scan is a series of detailed X-ray pictures that gives a 3 dimensional (3D) picture of the body. This test can help to pinpoint enlarged lymph nodes and abnormalities in other organs.  

While you are waiting for results, it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through similar experiences.

 

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

 

 

Bone marrow test

Blood cells are made in the bone marrow. Rarely, your specialist may want to look at a sample of bone marrow as well as a blood sample. You may hear this test called a bone marrow aspiration, a bone marrow biopsy or a trephine biopsy. It may be possible to see signs of CLL earlier in the bone marrow than in the blood.

  • In a bone marrow aspiration, the doctor puts a thin needle into one of your bones to draw out some of the liquid bone marrow from the centre
  • In a bone marrow biopsy, the doctor uses a slightly larger needle to remove a small amount of bone and marrow together

An aspiration and biopsy are usually done at the same time. Usually, the doctor takes the samples from one of your hipbones. There is more information about having a bone marrow test in the cancer tests section.

 

Tests for gene changes

Laboratory tests can be done on the blood or bone marrow cells you've given. Your haematologist may order a test to look for abnormalities in the leukaemia cell genes. This test is called FISH. FISH stands for fluorescent in situ hybridization. The FISH technique makes particular abnormalities in genes glow (fluoresce) and so makes them easier to see. Using this technique, doctors can now pick up abnormal genes in the cells of 80 out of every 100 people with chronic lymphocytic leukaemia (80%). FISH helps doctors to divide CLL into different groups. This helps with decisions about which treatment a person needs. So doctors are able to target treatments more effectively.

 

Tissue typing

Tissue typing is a blood test to see if the tissues of a donor and patient match. You will only need to have tissue typing if your specialist thinks a stem cell or bone marrow transplant may be the right treatment for you. In this treatment you have high dose chemotherapy or radiotherapy followed by bone marrow or stem cells from a donor. Only a handful of bone marrow or stem cell transplants are carried out each year for CLL. 

You can find out more about tissue typing on our page about how blood is matched for bone marrow transplant.

If your doctor wants you to have this test, they will also want to test any brothers or sisters you have who might donate stem cells or bone marrow to you. There is a 1 in 4 chance of a brother or sister being a perfect match.

 

CT scan

Rarely, your haematologist may ask for you to have a CT scan if you have not already had one. A CT scan is a series of detailed X-ray pictures that give a 3 dimensional (3D) picture of the body. This test can help to pinpoint enlarged lymph nodes and abnormalities in other organs. CT scans are not a routine test for CLL but you may be asked to have one as part of a clinical trial. We have more detailed information about having a CT scan.

You can find information on many different types of tests in the cancer tests section.

 

After the tests

Your doctor will ask you to go back to the hospital when your test results have come through. But this may take a little time, even if only a week or two. This is a very anxious time for most people. While you are waiting for results, it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through similar experiences.

Cancer Chat is Cancer Research UK's online discussion forum where you can talk online to other people affected by cancer, share experience and find information.

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Updated: 21 April 2015