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

Physical findings in someone with leukemia may include:

• Rashes that look like broken blood vessels in the skin or bruises
• Eye changes
• Infected wounds
• Liver enlargement
• Lymph node swelling
• Pale skin
• Spleen enlargement
• Weight loss

Tests that may be used to evaluate leukemia include:

• Coagulation profile
• Complete blood count
• Peripheral blood smear:
• Usually shows abnormally high numbers of lymphocytes. The lymphocytes will also have an abnormal shape, size or character when viewed under a microscope.
• Bone marrow aspiration and 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
• Cytogenic analysis:
• Detects DNA abnormalities in lymphocytes
• Immunophenotype:
• Detects CD5 and CD23 positive B cells
• Chest x-ray

Imaging tests that may be used to evaluate leukemia include:

• Bone x-rays
• CT scanning of the abdomen
• CT scanning of the chest
• CT scanning of the head
• MRI scan of the abdomen
• MRI scan of the chest
• Spinal tap (lumbar puncture)

For more information:

• Acute lymphocytic leukemia evaluation
• Acute myelogenous leukemia evaluation
• Chronic lymphocytic leukemia evaluation
• Chronic myelogenous leukemia evaluation