Diagnosing leukaemia

Tuesday 30 April, 2013

Reviewed: Annie Angle cancer nurse, Diploma Oncology Nursing, Royal Marsden, London

On this page: Symptoms of acute leukaemiaSymptoms of chronic leukaemia | Doctors and other health professionals who treat leukaemia | How leukaemia is diagnosed | Blood test | Bone marrow biopsy | Lymph node biopsy | Lumbar puncture (‘spinal tap')


Symptoms of acute leukaemia

The symptoms of acute leukaemia usually appear quite suddenly, as this type of leukaemia develops quickly. Symptoms include:

  • weakness, tiredness and looking ‘washed out', which may be due to reduced numbers of red blood cells.
  • bleeding that takes a long time to stop, for example, heavy nosebleeds or bruising easily, which may be due to a decrease in platelets.
  • regular infections and high temperatures, which may be due to your white blood cells not working properly.
  • pain in the bones and joints.

Symptoms of chronic leukaemia

The symptoms of chronic leukaemia develop over months or years. Chronic means lasting over a long time. The symptoms are like those of acute leukaemia but the lymph nodes, spleen and liver also become larger. Anaemia may be a symptom of chronic leukaemia. However, most people with chronic lymphocytic leukaemia don't know that they have the disease. They may only find out while having a check for another medical problem.

Chronic myeloid leukaemia usually progresses slowly at first. However, it may become more active and more like an acute leukaemia after several years.

The symptoms of leukaemia are similar to symptoms of some other common conditions. If you're concerned about your symptoms you should see your doctor.

Doctors and other health professionals who treat leukaemia

Your doctor will examine you and refer you for tests to see if you have cancer. This can be a worrying and tiring time, especially if you need to have several tests. If the tests show you have or may have cancer, your doctor will refer you to a specialist, who will advise you about treatment options.

You should expect to be cared for by a team of health professionals from the relevant major fields (see following list). Ideally, all your tests and treatment should be available at your hospital. This may not be possible in some non-metropolitan areas.

Specialists and other health professionals who care for people with leukaemia include:

  • haematologists and medical oncologists, who diagnose and treat people with blood diseases and usually give medication for leukaemia
  • surgeons, who specialise in biopsies and other surgical procedures
  • dietitians, who will recommend the best diets to follow while you're in treatment and recovery
  • nurses and general practitioners, who will help you through all stages of your cancer
  • social workers, psychologists, counsellors, physiotherapists and occupational therapists, who will advise you on support services and help you to get back to normal activities
  • a palliative care team to help with symptom management and emotional support for you and your family if your cancer can't be cured.

You may only see a few of these people. However, it's important to know you do have several health professionals supporting you through your treatment. Talking to them about your concerns can help you manage your disease and treatment in the best possible way.

Other people may be involved in supporting you through your cancer and its treatment such as your close family and friends, volunteers and spiritual care workers.

How leukaemia is diagnosed

Leukaemia can be diagnosed by examining samples of your blood and bone marrow under a microscope. A lymph node biopsy may also be recommended.

Blood test

Leukaemia is suspected if a blood test shows large numbers of abnormal white blood cells and low numbers of normal white blood cells, red blood cells and platelets.

Bone marrow biopsy

This test can help work out which leukaemia you have.

A small amount of fluid will be collected from your bone marrow with a syringe. A small core of bone marrow will also be removed. The samples will be examined under a microscope. They'll also be examined for changes to genes that may be important for classifying and following the disease.

Having a bone marrow biopsy can be uncomfortable, so you'll have a local anaesthetic. You may also have a drug to relax you and make you more comfortable.

If you're treated for leukaemia, blood tests and bone marrow tests during and after treatment will check how the treatment's working.

Lymph node biopsy

If you have enlarged lymph nodes, your doctor may recommend a biopsy to see if this is related to leukaemia.

Tissue will be removed from the affected lymph node and examined under a microscope. You may have a local or general anaesthetic, depending on where the affected node is. You may have the procedure while you're an outpatient or during a brief stay as an inpatient.

Lumbar puncture (‘spinal tap')

Your doctor may recommend a lumbar puncture. This is to check for leukaemic cells in the fluid around the brain and spinal cord.

A fine needle will be put into a space between bones in your lower back. Some fluid will be removed from around your spine. This will be looked at under a microscope.

A local anaesthetic will reduce the pain and discomfort felt during this procedure. Some people worry about having this procedure: you may have a sedative if you wish. Discuss this with your doctor.

Updated: 30 Apr, 2013