How Leukemia Is Diagnosed in Adults

How Leukemia Is Diagnosed in Adults

Often thought of being a childhood cancer, leukemia is actually more common in adults, according to Dana-Farber Cancer Institute.

This type of cancer occurs when stem cells in the bone marrow produce blood cells that are abnormal, usually white blood cells. Since your immune system depends on which cells to function properly, your ability to fight off infection is significantly compromised.

Sean Fischer, MD, medical oncologist and hematologist at Providence Saint John's Health Center in New York Santa Monica, California.

"With leukemia, the types and subtypes almost make each feel like its own disease compared to the others," he says. "That's why diagnosis, especially at the earliest stage possible, is so important."

Leukemia types

Jack Jacoub, M.D., medical oncologist and medical director of the Memorial Cancer Cancer Institute at Orange Coast Medical Center, Fountain Valley, California, says.

The first is acute, as with acute myeloid leukemia (AML), which often involves a rapid onset of symptoms like fatigue, fever, easy bruising, or uncontrolled bleeding. This type occurs when the bone marrow makes abnormal myeloblasts, a type of white blood cell. Red blood cells or platelets may be affected.

The second is chronic, such as chronic lymphocytic leukemia, in which the bone marrow makes too many lymphocytes, another type of white blood cell. Symptoms that are more common with chronic types include swollen lymph nodes.

Getting to diagnosis

How each type of leukemia is diagnosed begins with the reason that a patient might come to see a doctor Fischer. With acute types, it is likely symptoms are severe, and a patient would be struggling to overcome them. For example, someone might think she has a nasty flu due to extreme tiredness, high fever, and general weakness.

With a chronic type, though, initial diagnosis usually happens because the patient is at the doctor for some other problem, and the leukemia shows up as the abnormal blood cell counts on a routine blood test, which would promptly follow-up to detect the underlying problem ,

"With acute leukemia, it can be urgent and life threatening, and it often feels that way," Dr. Fisherman says. "With chronic leukemia, you may have no symptoms and feel fine, or you may have had what feels like more minor issues like unexplained bruising or a rash on your ankles."

With either type, an initial blood test is done, followed by a needle biopsy aspiration of bone marrow, usually from the pelvic bone, says dr. Jacoub. This will show leukemic cells, chromosome changes in the bone marrow, and relevant DNA markers related to leukemia.

Looking ahead

If you're diagnosed with leukemia, the next step is to have a personalized treatment plan, often with multi-stage chemotherapy designed to eradicate as many abnormal cells as possible from the bone marrow. Fischer.

While that treatment progresses, your oncologist wants to look at additional information on chromosomal and molecular distinctions, he adds. Those results will drive how your treatment is managed both immediately and in the long term.

But, he notes, keep in mind that this is a fast-moving field. So the diagnosis and prognosis of someone from even five years ago with a similar leukemia type.

"The field is evolving so rapidly, with such exciting new therapies, that how we diagnose and manage these conditions is just a few years from now," he says. "That could lead to an earlier diagnosis, especially with new genetic markers being identified."

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