Leukemia Diagnosis

And when you come to us for care, we start by ensuring you receive a thorough and precise leukemia diagnosis. Because that’s the key to selecting the most effective treatment.

Winship has a team of pathologists dedicated solely to hematological (blood-borne) cancers, meaning we are experts in leukemia diagnosis. But we don’t stop there. We go further to analyze your cancer on a molecular level to determine exactly what’s driving it — so we can figure out the best way to stop it. Because your leukemia is unique, and your treatment plan should be too.

Leukemia is a rare form of cancer that affects blood and bone marrow cells and hinders the body's ability to fight infection. The majority of those diagnosed are over the age of 55, but more than 7% of those diagnosed in recent years have been under the age of 20, making it the most common type of cancer among children.

There are several subtypes of leukemia, most of them typically occurring in older adults.

• Acute lymphoblastic leukemia (ALL). This subtype is the most common variant in younger individuals, making up 80% of pediatric cases.
• Acute myeloid leukemia (AML). This is most common among older adults, and it is also the most aggressive form. Early diagnosis is key to ensuring the best prognosis.
• Chronic myeloid leukemia (CML). CML is caused by changes to an individual’s genetic code. An abnormal gene (BCR-ABL) may form, which causes a cell to become leukemic, or cancerous.
• Chronic lymphocytic leukemia (CLL). The most common form of leukemia found in adults, CLL originates in lymphocyte cells in the bone marrow and can take months to several years to show symptoms.
• Other less common variants. These include mature B-cell and T-cell leukemias and NK cell-related leukemias.

Because leukemia is a disease that impacts blood cells and can easily be transported via the bloodstream, these cancers have a higher-than-normal chance of spreading to other parts of the body. All forms of leukemia, particularly acute leukemias which are fast-growing, require expertise and specialized therapy, often in the form of a clinical trial.

At Winship, we take a multi-stage approach to ensure every patient gets a thorough and accurate leukemia diagnosis. Leukemia is sometimes discovered incidentally, meaning it’s detected by chance after receiving a blood test for a different condition. In other cases, patients experience symptoms that send them to the doctor, eventually leading to a leukemia diagnosis.

Because no two leukemias are the same — even those of the same type — your cancer will differ from another patient’s. And it’s imperative we understand your cancer in order to properly treat it. We know you’re anxious to move forward with treatment, but getting a full and precise leukemia diagnosis is critical, and it won’t take long, we promise.

The following tests help us make or confirm a leukemia diagnosis. If you’ve already had any of these diagnostic tests done at another center, please let us know so we can avoid repeat testing where possible.

Blood testing. The first step in a leukemia diagnosis is a blood draw. In our lab, your blood will be analyzed, and a complete blood count will be performed to see how many of each type of blood cells you have. Leukemia is diagnosed when you have too many immature blood cells and not enough healthy blood cells. Other blood tests also will be completed at the same time to check liver and kidney function, which can be affected by leukemia.

Bone marrow biopsy. To confirm a leukemia diagnosis, your doctor will collect a sample (biopsy) of bone, bone marrow and blood that will then be tested in the lab for the presence of leukemia and to determine what type. At Winship, we perform bone marrow aspiration (the use of a needle to collect a tissue sample) right in the doctor’s office. Surgery is not required.

Molecular pathology. Once we’ve confirmed a leukemia diagnosis, we go further. Our molecular pathologists will conduct genomic profiling to look at the DNA of your cancer to identify genetic mutations and biomarkers, or cell characteristics. Winship scientists, genomic and tumor sequencing experts will analyze what’s driving your particular leukemia and then work with your oncologists to determine which types of treatment — including novel treatments still in clinical trial — will work best against it.