Acute Lymphoblastic Leukemia Symptoms & Diagnosis

Symptoms

These may be caused by other, less serious health conditions. You should see a doctor if you or your child is experiencing:

• Weakness
• Tiredness
• Fever
• Paleness (a sign of anemia )
• Easy bruising or bleeding
• Petechiae (flat, pinpoint spots under the skin caused by bleeding)
• Shortness of breath
• Weight loss
• Loss of appetite
• Bone or joint pain
• Stomach pain
• Pain or a feeling of fullness below the ribs
• Painless lumps in the neck, underarms, stomach, or groin
• Swelling of the liver and/or spleen

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor may also check for swelling of the liver, spleen, or lymph nodes. You will likely be referred to an oncologist. This is a doctor who specializes in treating cancer.

Tests may include the following:

• Blood tests—to check for changes in the number or appearance of different types of blood cells
• Bone marrow aspiration—removal of a sample of liquid bone marrow to test for cancer cells
• Bone marrow biopsy —removal of a sample of liquid bone marrow and a small piece of bone to test for cancer cells
• Spinal tap —removal of a small amount of cerebrospinal fluid to check for cancer cells
• Routine microscopic exam—examination of a sample of blood, bone marrow, lymph node tissue, or cerebrospinal fluid
• Bone, blood marrow, lymph node tissue, or cerebrospinal fluid tests—to distinguish among types of leukemia
• Cytogenetic analysis—a test to look for certain changes of the chromosomes (genetic material) of the lymphocytes; certain genetic abnormalities include:
  • Relocation of genetic material from one chromosome to another
  • Presence of a particular gene (Ikaros)
  • Presence of a variant gene, which controls an enzyme that influences folate metabolism
• Immunophenotyping—examination of the proteins on cell surfaces and the antibodies produced by the body; to distinguish lymphoblastic from myeloid leukemia and determine types of therapy
• Chest x-ray —x-rays of the chest that may detect signs of lung infection or enlarged lymph nodes in the chest
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
• Gallium Scan and Bone scan —injection of a radioactive chemical into the bloodstream to detect areas of cancer or infection
• Ultrasound —a test that uses sound waves to examine masses and organs inside the body