Tests for chronic myeloid leukaemia (CML)

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 order 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, he or she will suggest 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. You will probably have blood tests straight away. But you may need to make other appointments to go back to the hospital for some of the other tests.

There are several different tests your haematologist might ask for such as

• Blood tests
• Bone marrow test
• X-rays
• Ultrasound scans
• DNA analysis
• Tissue typing

Blood tests

The blood test involves taking a small amount of blood from a vein in your arm. This is done by using a low pressure suction device attached to the blood sample bottle or by using a needle and syringe. The blood is sent to the blood laboratory, where a pathologist looks at it 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.

Bone marrow test

The blood cells are made in the bone marrow. 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 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 hip bones. There is more information about having a bone marrow test in the cancer tests section.

X-rays

Your doctor may want you to have X-rays, for example of your chest, to rule out any other causes of your symptoms.

Ultrasound scans

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 of CancerHelp UK.

DNA analysis

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 abnormalities in your chromosomes. The tests are called cytogenetic tests or molecular analysis.

About 95 out of every 100 people with CML (95%) have the 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.

Tissue typing

This is also called HLA typing. HLA stands for Human Leucocyte Antigen. Leucocyte is another word for white blood cell. Antigens are proteins on the surface of cells throughout the body. Your antigens are inherited from your parents.

If you were to have a stem cell or bone marrow transplant, your doctors would need to look at your antigens and the donor's antigens. By doing this, your doctors can see if there is a good enough match for a transplant. The more HLA markers you and your donor have in common, the less chance there is that you will have complications after your transplant.

If your doctor thinks that stem cell or bone marrow transplant may be a possible treatment for you, they may want you to have this test. They will also want to test any brothers or sisters you have, who might be able to donate stem cells or bone marrow. 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. 

Our chronic leukaemia organisations page gives details of people who can help and support you. You can also find details of counselling organisations in our counselling section.