Diagnosis of Chronic Lymphocytic Leukemia

Diagnosis of Chronic Lymphocytic Leukemia

If the symptoms suggest the possibility of Chronic Lymphocytic Leukemia (CLL), some of these tests may be used to diagnose it:
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells, white blood cells, and platelets.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the blood sample made up of red blood cells.
  • Cytogenetic analysis: A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for changes in the structure or number of chromosomes in the lymphocytes.
  • Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if malignant lymphocytes (cancer) began from the B lymphocytes or the T lymphocytes.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for abnormal cells.

Factors Affecting Prognosis and Treatment Options

Treatment options for Chronic Lymphocytic Leukemia depend on:
  • The stage of the disease.
  • Red blood cell, white blood cell, and platelet blood counts.
  • Whether there are symptoms, such as fever, chills, or weight loss.
  • Whether the liver, spleen, or lymph nodes are larger than normal.
  • The response to initial treatment.
  • Whether the CLL has recurred (come back).
The prognosis (chance of recovery) depends on:
  • Whether there is a change in the DNA and the type of change, if there is one.
  • Whether lymphocytes are spread throughout the bone marrow.
  • The stage of the disease.
  • Whether the Chronic Lymphocytic Leukemia gets better with treatment or has recurred (come back).
  • Whether the CLL progresses to lymphoma or prolymphocytic leukemia.
  • The patient’s general health.

Staging

Staging is the process used to find out how far the cancer has spread. It is important to know the stage of the disease in order to plan the best treatment. The following tests may be used in the staging process:
  • Bone marrow aspiration and biopsy
  • Chest x-ray
  • MRI
  • CT scan
  • Blood chemistry studies
  • Antiglobulin test
The following stages are used for chronic lymphocytic leukemia: Stage 0— In stage 0 chronic lymphocytic leukemia, there are too many lymphocytes in the blood, but there are no other symptoms of leukemia. Stage 0 chronic lymphocytic leukemia is indolent (slow-growing). Stage I— In stage I chronic lymphocytic leukemia, there are too many lymphocytes in the blood and the lymph nodes are larger than normal. Stage II-– In stage II chronic lymphocytic leukemia, there are too many lymphocytes in the blood, the liver or spleen is larger than normal, and the lymph nodes may be larger than normal. Stage III— In stage III chronic lymphocytic leukemia, there are too many lymphocytes in the blood and there are too few red blood cells. The lymph nodes, liver, or spleen may be larger than normal. Stage IV— In stage IV chronic lymphocytic leukemia, there are too many lymphocytes in the blood and too few platelets. The lymph nodes, liver, or spleen may be larger than normal and there may be too few red blood cells. Refractory Chronic Lymphocytic Leukemia— Refractory chronic lymphocytic leukemia is cancer that does not get better with treatment. If you have symptoms associated with CCL, contact us to request an appointment with our oncology specialists to to begin diagnostic testing or to obtain a second opinion on a recent diagnosis.