Tests for ALL

If you have worrying symptoms, you usually begin by seeing your family doctor. Your GP will examine you and ask about your general health and symptoms. This will include

• What your symptoms are
• When you get them
• Whether anything you do makes them better or worse

Your doctor will examine you by

• Feeling for swollen organs or glands
• Looking for signs of abnormal bleeding

Your GP may also order a blood test.

If your GP suspects that you have leukaemia, they will refer you to a specialist doctor called a haematologist (pronounced heem-at-oll-oh-jist). Haematologists treat diseases of the blood. Your haematologist will ask you to have some tests.

At the hospital, the tests you have may include

• Blood tests
• Bone marrow test
• Lumbar puncture
• Chest X-ray
• CT scan

Blood tests

Your doctor or nurse takes a small amount of blood from a vein in your arm, using a needle and syringe. They send the blood to the laboratory. A haematologist looks at the sample under a microscope to count the different blood cells. This is called a full blood cell count (FBC). The pathologist also checks whether the cells look normal or not.

Your doctor might also do other blood tests to see how well your liver and kidneys are working.

Bone marrow test

Blood cells grow in your bone marrow. So, your specialist may want to check a sample of your bone marrow for signs of leukaemia or other illnesses. There are 2 different types of bone marrow test. You may hear them called

• Bone marrow aspiration
• Bone marrow biopsy or trephine biopsy

In a bone marrow aspiration, the doctor puts a thin needle into the centre of one of your bones, to draw out some of the liquid bone marrow. Usually, the doctor takes the sample from one of your hip bones. You will have a local anaesthetic injection first.

In a bone marrow biopsy, the doctor uses a slightly larger needle to remove a small amount of bone and marrow together.

You usually have an aspiration and biopsy at the same time. There is information about having a bone marrow test in the section about cancer tests.

As well as looking at the bone marrow cells, the haematologist may test for changes in your chromosomes. These tests are called cytogenetics (pronounced sigh-toe gen-et-ics). They may also do tests for particular proteins that certain types of leukaemia cells make. Your doctor may call this immunophenotyping (pronounced imm-you-know-fee-no-typing).

Lumbar puncture

A lumbar puncture shows if there are leukaemia cells in the fluid around your brain and spine. The fluid is called cerebrospinal fluid (pronounced sare-eh-bro-spy-nal fluid) or CSF. Your doctor will put a needle into your spine and collects a small amount of fluid that drains out. Our cancer tests section has information about having a lumbar puncture.

Chest X-ray

You may have X-rays to check your general health. In acute lymphoblastic leukaemia, you sometimes have a 'lump' of leukaemic cells growing in the centre of the chest, in the area around the heart. This area is called the mediastinum (pronounced mee-dee-a-sty-num) and the lump is called a mediastinal mass.

CT scan

A CT scan is a type of computerised X-ray. You may have a CT scan to check for particular signs of leukaemia (such as the mediastinal mass described above) or to check your general health. There is information about having a CT scan in our cancer tests section.