Leukemia is a cancer that starts in the blood and bone marrow. It is categorized by how fast the disease progresses and by the type of white blood cell it affects. The four major types of leukemia are acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Knowing your type, subtype and the treatment options available will help you make the important decisions ahead.

Diagnosing Leukemia

People with leukemia often have low numbers of healthy white blood cells, red blood cells and platelets that increase the risk for infection, anemia and bleeding.

To diagnose which form of leukemia you may have, your doctor may perform a physical exam in addition to any of the following tests.

  • Blood tests, including a complete blood count and a peripheral blood smear.
  • Bone marrow aspiration and biopsy (often done at the same time) to remove bone marrow samples for examination. 
  • Lumbar puncture (spinal tap) to see if leukemia cells are in the cerebrospinal fluid, which surrounds the brain and spinal cord. 
  • Specialized genetic tests, such as flow cytometry, cytogenetics with fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR). Also called molecular profiling, these tests help classify the subtype of leukemia. Some doctors are now ordering “sequencing,” where a great number of genes in the leukemic cells’ DNA are studied.
  • Imaging tests (CT, PET, MRI and X-rays) to help determine the extent of disease.