Posts Tagged ‘Blood cells’

How is Leukemia diagnosed ?

Leukemia can be diagnosed with a variety of tests, and understanding what each test is and what it looks for can make the tests a little less confusing. Doctors sometimes find leukemia after a routine blood test. If you have symptoms that suggest leukemia, your doctor will try to find out what’s causing the problems. Your doctor may ask about your personal and family medical history.

- Physical Examination
An exam is much like any doctor’s appointment; the doctor will take a detailed medical history and thoroughly examine the whole body.
- Blood Tests
To diagnose leukemia, a number of blood tests are performed. These tests are used to evaluate the type and quantity of blood cells that are present, the blood chemistry, and other factors.
- Full blood count
It is used to establish the numbers of different blood cell types in the circulation. A low number of red or white blood cells is described as anemia or leukopenia, respectively.
- Bone Marrow Biopsy
A biopsy takes a small sample of bone marrow tissue from the body. The doctor asks the patient to lie on his or her side and nurses clean the biopsy site with iodine or alcohol. After the site is cleaned, the biopsy site is numbed with a local anesthetic. The doctor uses either a very fine needle to draw out only bone marrow tissue, or a thicker needle to take a small sample of bone and bone marrow. The bone marrow sample is examined under a microscope to check for leukemia cells.
- Cytogenetics
It is a newer type of testing for leukemia. Cytogenetic testing uses a sample taken from a blood draw or a bone marrow or lymph node biopsy. The sample’s chromosomes are microscopically examined for abnormalities that indicate damage to the cells’ DNA.
- Spinal tap
The doctor uses a long, thin needle to remove fluid from the lower spine. The procedure takes about 30 minutes and is performed with local anesthesia. You must lie flat for several hours afterward to keep from getting a headache.
- Chest x-ray
An x-ray can show swollen lymph nodes or other signs of disease in your chest.
- CT scan of the head, chest, and belly, to find out whether leukemia has spread there.
- Lumbar puncture is to find out whether leukemia cells are in your cerebrospinal fluid (CSF).
- Differential blood count (DBC)
It is used to determine the relative proportion of blood cell types within the bloodstream. In particular, the percentage of immature leukemic “blast” cells is noted.
- Hematocrit assay
It is used to determine the proportion of the blood that is occupied by erythrocytes (red blood cells). In adult men, normal is about 46% (39.8–52.2) and in adult women, it is about 40.9% (34.9–46.9).

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Introduction to Chronic lymphocytic leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.
The term “chronic” in chronic lymphocytic leukemia comes from the fact that it typically progresses more slowly than other types of leukemia. The “lymphocytic” in chronic lymphocytic leukemia comes from the cells affected by the disease — a group of white blood cells called lymphocytes, which help your body fight infection.

In CLL, too many blood stem cells develop into abnormal lymphocytes and do not become healthy white blood cells. The abnormal lymphocytes may also be called leukemic cells. The lymphocytes are not able to fight infection very well. Also, as the number of lymphocytes increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may result in infection, anemia, and easy bleeding.

Causes of CLL

Doctors do not know what causes the cell-change that leads to CLL. The reason for this increase in B cells is unknown. There is no link to radiation, cancer-causing chemicals, or viruses. CLL primarily effects adults. The average age of patients with this type of leukemia is 70. It is rarely seen in people younger than 40.

Symptoms of CLL

Symptoms usually develop gradually. Many cases of CLL are detected by routine blood tests in people who do not have any symptoms.
- Abnormal bruising (occurs late in the disease).
- Enlarged lymph nodes, liver, or spleen.
- Excessive sweating, night sweats.
- Fatigue.
- Fever.
- Infections that keep coming back (recur).
- Loss of appetite or becoming full too quickly (early satiety).
- Unintentional weight loss.

Diagnosis of CLL

The diagnosis of CLL is usually made from blood and bone marrow tests.
Blood Tests : The testing for CLL includes blood cell counts and a blood cell examination.
- Blood cell counts : A person with CLL will have a high lymphocyte count. He or she may also have a low red cell count and a low platelet count.
- Blood cell examination : The CLL cells are usually examined with an instrument called a “flow cytometer.” The test is called flow cytometry or immunophenotyping. The test is done to find out if CLL is the reason for the high lymphocyte count. Flow cytometry also shows if the CLL is B-cell CLL or T-Cell CLL. B-cell CLL is most common.
- Immunoglobulin Test : Doctors check the immunoglobulin level in the blood. Immunoglobulins are proteins that help the body fight infection. People with CLL may have low levels of immunoglobulins. A low immunoglobulin level may be the cause of repeated infections.

Bone Marrow Tests and Cytogenetic Tests
Bone marrow tests are not usually needed to make a CLL diagnosis. But it’s often helpful to have a bone marrow aspiration and a bone marrow biopsy before treatment begins. The results of these tests serve as a baseline that is used later on to assess the effects of treatment.
- FISH or fluorescence in situ hybridization is a test used to see if there are changes to the chromosomes of the CLL cells.

Goals of CLL Therapy

It is important to get treatment in a center where doctors are experienced in the care of patients with CLL. The goals of CLL treatment are to :
- Slow the growth of CLL cells.
- Provide long periods of remission (when there are no signs of CLL and/or people feel well enough to carry on their day-to-day activities).
- Help people to feel better if they have infections, fatigue or other symptoms.

Acute lymphocytic leukemia (ALL)

Acute lymphocytic leukemia (ALL) is a fast-growing cancer of the white blood cells. Lymphocytes are a type of white blood cell that the body uses to fight infections. In ALL, the bone marrow makes lots of unformed cells called blasts that normally would develop into lymphocytes. However, the blasts are abnormal. They do not develop and cannot fight infections. The number of abnormal cells (or leukemia cells) grows quickly. They crowd out the normal red blood cells, white blood cells and platelets the body needs.

Causes and Risk Factors

There are some factors that are known to increase a person’s risk of developing ALL, including previous treatment with chemotherapy or radiation therapy, exposure to large amounts of radiation (such as an atomic bomb), or the presence of a genetic disorder (i.e. Down’s syndrome, Klinefelter’s syndrome). Research has identified viruses, such as Epstein-Barr, HTLV1, and HIV, as potential causes in some cases.

Symptoms of ALL

- Aches in arms, legs, back
- Black-and-blue marks for no apparent reason
- Enlarged lymph nodes
- Fever without obvious cause
- Headaches
- Pale-looking skin
- Pinhead-size red spots under the skin
- Prolonged bleeding from minor cuts
- Shortness of breath during physical activity
- Tiredness
- Vomiting.

Diagnosis of ALL

ALL is diagnosed when blood and bone marrow samples show a large number of abnormal lymphocyte blasts. To find out the type of ALL and how well it might respond to treatment, doctors test samples taken from the blood and bone marrow to learn:
- The size and number of leukemia cells.
- The type of lymphocyte affected — the leukemia cells can begin from one of two types of lymphocytes, B cells or T cells.
- What changes appear in the chromosomes of the leukemia cells. This is called cytogenetics.
Doctors also use a test called a lumbar puncture (or spinal tap) to find out whether there are leukemia cells in the fluid around the brain and spinal cord.