Tests for chronic myeloid leukaemia (CML)
This page has information about what happens when you go to your doctor with symptoms of chronic myeloid leukaemia. There is information about
Tests for chronic myeloid leukaemia (CML)
You usually begin by seeing your GP. They will ask about your general health and examine you. Your GP may order a blood test. Sometimes CML is picked up by chance when you have a routine blood test. Your doctor will feel for any swollen glands or organs and look for signs of abnormal bleeding.
At the hospital
If your GP suspects that you may have leukaemia, they will suggest that you see a specialist called a haematologist. This is a doctor who treats diseases of the blood. Your haematologist will need to order some tests to check what is wrong. They may ask you to have blood tests, a bone marrow test, X-rays, an ultrasound scan or a combination of these. You will probably have to make other appointments and go back to have some of these tests.
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.
You can view and print the quick guides for all the pages in the Diagnosing CML section.
If you have symptoms that are worrying you, the first step is usually to go to your GP. Your GP will examine you, and ask about your general health and symptoms. This will include what the symptoms are, when you get them and whether anything you do makes them better or worse. Your doctor will also ask questions about your personal and family medical history. During your examination, your doctor will feel for any swollen glands or organs, or for signs of abnormal bleeding. Your GP may ask you to have a blood test.
Often chronic myeloid leukaemia has no symptoms and is picked up by chance from a routine blood test.
If your GP suspects that you have any type of leukaemia, they will suggest that you see a specialist called a haematologist. Haematologists are doctors who treat diseases of the blood. Your haematologist will need to order some tests to help find out if anything is wrong.
Your haematologist will ask you to have some of the following tests.
The blood test involves taking a small amount of blood from a vein in your arm, using a small needle put into the vein. In the blood laboratory, a pathologist looks at the blood under a microscope and counts the cells. This is called a full blood cell count or FBC. The pathologist will also judge whether the cells look normal or not.
The blood cells are made in the bone marrow. Bone marrow is the soft area in the middle of some of our bones, such as the hip bones, breast bone or legs. You will need to give a sample of bone marrow as well as a blood sample because it may be possible to see earlier signs of CML in the bone marrow. You may hear this test called a bone marrow aspiration, a bone marrow biopsy or a trephine biopsy.
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. 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 hip bones. There is detailed information about having a bone marrow test in the cancer tests section.
Your doctor may want you to have X-rays, for example of your chest, to rule out any other causes of your symptoms.
This test uses high frequency sound waves to create a picture of the body organs. You may need to have an ultrasound of your liver and spleen. But if your doctor can clearly feel that your liver or spleen are enlarged, you may not need this test. There is more information about having an ultrasound scan in the cancer tests section.
These are laboratory tests carried out on the blood or bone marrow cells you've given. These tests are also called chromosome analysis. Your haematologist may order these tests to look for changes (abnormalities) in your chromosomes. The tests are called cytogenetic tests or molecular analysis.
About 95 out of every 100 people with CML (95%) have an abnormality called the Philadelphia chromosome. It is caused by some of the DNA from one chromosome (number 9) moving over to another chromosome (number 22). This type of genetic change is called a translocation. A test for this can diagnose chronic myeloid leukaemia.
If your doctor thinks that a stem cell or bone marrow transplant may be a possible treatment for you, they may want you to have this test. In a stem cell or bone marrow transplant you have stem cells from a donor given into your bloodstream. The proteins on the surface of the donor cells need to be as close a match to your own as possible. The tissue typing test looks at proteins called antigens or HLA markers on the surface of cells.
By doing this test, your doctors can see if the donor's stem cells or bone marrow are a good enough match for a transplant. The more proteins you and your donor have in common, the lower the chance that you will have complications after your transplant. Family members, such as brothers or sisters, may also need to have this test to see if their proteins match yours. There is a 1 in 4 chance of a brother or sister being a perfect match.
Your doctor will ask you to go back to the hospital when your test results have come through. This may take a little time, even if only a week or two. It is a very anxious time for many people. While you are waiting for your 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.
If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or you can go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.
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