The evaluation of acute lymphocytic leukemia begins with a history and physical exam.

Physical findings in those with acute lymphocytic leukemia may include:

• Rash:
• That looks like bruises or broken blood vessels in the skin
• Liver enlargement
• Lymph gland swelling
• Thrush
• Pale skin
• Spleen enlargement
• Unintentional weight loss
• Abnormal retina

Testing is required to make the diagnosis of acute lymphocytic leukemia.

Tests that may be used to evaluate acute lymphocytic leukemia include:

• Coagulation profile
• Complete blood count
• Peripheral blood smear
• Bone marrow biopsy
• Philadelphia chromosome analysis:
• Detects abnormal DNA that may be present in leukemia
• A type of karyotype that is used to identify a chromosomal abnormality that is often associated with chronic myelogenous leukemia or CML. The analysis specifically looks for an exchange (translocation) of genetic material between chromosomes 9 and 22.
• Immunophenotyping:
• Determines the type of abnormal lymphocyte
• Chest x-ray
• Bone x-rays
• CT scan of the abdomen
• CT scan of the chest
• CT scan of the head
• MRI scan of the chest
• MRI scan of the abdomen
• Ultrasound of the abdomen
• Spinal tap