The first step in diagnosis is usually a physical examination and medical history. Your doctor will check for signs of disease. He or she will ask about your health habits and past illnesses and treatments.
To determine whether you have ALL, your doctor will also need to examine your blood and bone marrow, and possibly other cells and tissues. The following tests and procedures may be used:
Blood cell count and other blood tests – Blood will be drawn from your arm to check for the numbers and appearance of blood cells.
Bone marrow aspiration and biopsy – A small sample of bone and liquid bone marrow is taken from the hipbone or breastbone with a long needle. A specially trained doctor checks for abnormal cells.
Cytogenetic analysis – This test looks for specific changes in the genetic material of ALL cells.
Flow cytometry(immunophenotyping) – This examines the characteristics of a patient's cells. In ALL, it can help determine whether cancerous cells began from B lymphocytes or T lymphocytes.
These and other lab tests will help your doctor determine your subtype of ALL and your prognosis.
Once you have been diagnosed with ALL, you may need several additional tests and procedures. These will help determine whether the cancer has spread beyond the blood and bone marrow. The results will also help to plan a course of treatment. These additional tests are likely to include:
Imaging tests, such as chest X-ray, computed tomography (CT) scan and ultrasound.
Lumbar puncture/spinal tap, which uses a needle to collect some fluid from the spinal column.
If you are diagnosed with leukemia, you may be referred to a hematologist/oncologist, a doctor who specializes in treating cancers and blood diseases.