When a patient comes for a consultation with specific symptoms, the doctor will carry out a thorough medical history review and perform a complete physical examination. The examination will focus on the possible growth of the liver, the spleen and the lymph glands located in the axilla zone, the groin, and the neck.
Simultaneously, a blood test will be performed and examined microscopically to check the blood cells for any possible immature or blast cells. The blood test can confirm the presence of leukaemia, although without specifying the exact type. In order to specify the form of leukaemia it is necessary for a specialist (hematologist) to carry out a bone marrow examination of the patient. This procedure, which is called a bone marrow aspiration, requires a puncture in a large bone (such as the hip bone or the sternum) in order to obtain a small amount of bone marrow which can be examined through a microscope. Another useful procedure is the bone marrow biopsy which is performed with a small needle to obtain a small amount of bone marrow and bone.
Illustration by Carmen Bueno
If the bone marrow examination reveals the presence of leukaemia cells, it is necessary to amplify the analysis of the cells in order to know the extent of the disease. A lumbar puncture can confirm the presence of abnormal cells in the fluid that occupies the space in and around the brain and spinal cord (cerebrospinal fluid). Through a range of other tests (radiographs, computed tomography, ultrasound scan) it is possible to detect signs of the disease in other locations such as the thorax or the abdomen.