Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to:
- Count the number of cells in a blood sample. A complete blood count may be used to count the number of lymphocytes in a blood sample. A high number of B cells, one type of lymphocyte, may indicate chronic lymphocytic leukemia.
Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine whether an increased number of lymphocytes is due to chronic lymphocytic leukemia, a different blood disorder or your body's reaction to another process, such as infection.
If chronic lymphocytic leukemia is present, flow cytometry may also help analyze the leukemia cells for characteristics that help predict how aggressive the cells are.
- Analyze lymphocytes for genetic abnormalities. A test called fluorescence in situ hybridization (FISH) examines the chromosomes inside the abnormal lymphocytes to look for abnormalities. Doctors sometimes use this information to determine your prognosis and help choose a treatment.
In some cases, your doctor may order additional tests and procedures to aid in diagnosis, such as:
- Tests of your leukemia cells that look for characteristics that could affect your prognosis
- Bone marrow biopsy and aspiration
- Imaging tests, such as computerized tomography (CT)
Once a diagnosis is confirmed, your doctor determines the extent (stage) of your chronic lymphocytic leukemia. Two different staging systems are used. Each assigns a stage — early, intermediate or advanced — that indicates the progression of a person's chronic lymphocytic leukemia. These levels are used to determine treatment options.
In general, people with early-stage disease don't require immediate treatment. Those with intermediate-stage disease and advanced-stage disease may be given the option to begin treatment right away.
Aug. 23, 2017
- Lichtman MA, et al. Chronic lymphocytic leukemia and related diseases. In: Williams Hematology. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/. Accessed Jan. 22, 2016.
- Niederhuber JE, et al., eds. Chronic lymphocytic leukemia. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014 http://www.clinicalkey.com. Accessed Dec. 22, 2015.
- Chronic lymphocytic leukemia. The Leukemia & Lymphoma Society. https://www.lls.org/sites/default/files/file_assets/cll.pdf. Accessed Feb. 3, 2016.
- Chronic lymphocytic leukemia treatment (PDQ). National Cancer Institute. http://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq. Accessed Jan. 3, 2016.
- When cancer doesn't go away. American Cancer Society. http://www.cancer.org/treatment/survivorshipduringandaftertreatment/when-cancer-doesnt-go-away. Accessed Jan. 3, 2016.
- Berger AM, et al. Cancer-related fatigue, version 2.2015. Journal of the National Comprehensive Cancer Network. 2015;13:1012.
- Shanafelt TD, et al. Phase 2 trial of daily, oral polyphenon E in patients with asymptomatic, Rai stage 0 to II chronic lymphocytic leukemia. Cancer. 2013;119:363.
- Green tea. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/home.aspx. Accessed Feb. 3, 2016.
- D'Arena G, et al. Regulatory T cell modulation by green tea in chronic lymphocytic leukemia. International Journal of Immunopathology and Pharmacology. 2013;26:117.
- Gazya (prescribing information). South San Francisco, Calif.: Genentech, Inc.: 2013. http://www.gazyva.com. Accessed Dec. 22, 2015.
- Imbruvica (prescribing information). Sunnyvale, Calif.: Pharmacyclics, Inc.: 2014. http://www.imbruvica.com. Accessed Dec. 22, 2015.
- Zydelig (prescribing information). Foster City, Calif.: Gilead Sciences, Inc.: 2014. https://www.zydelig.com. Accessed Feb. 4, 2016.
- Revlimid (prescribing information). Summit, NJ: Celgene Corporation: 2015. http://www.revlimid.com. Accessed Feb. 4, 2016.
Chronic lymphocytic leukemia