How Is Leukemia Diagnosed?

  • Mihai Merzianu, a pathologist at Roswell Park, uses the latest techniques in order to make the most accurate leukemia diagnosis.

Because there are several subtypes of leukemia, an accurate diagnosis is critical to creating a treatment plan that will work best for you.

Roswell Park is equipped with the most advanced imaging tools and pathology resources available. Our expert pathologists can diagnose your disease and also pinpoint unusual characteristics at the genetic or molecular levels — information that can determine whether you’re eligible to enroll in clinical trials of the latest targeted treatments, or whether you have any disease remaining after having previous therapy.

Standard diagnostic tests for leukemia include:

  • Physical exam: Your doctor checks for swollen lymph nodes, spleen or liver; bleeding; or skin lesions or lumps.
  • Blood tests: The lab does a complete blood count to check the number of white blood cells, red blood cells and platelets. Leukemia causes a very high level of white blood cells. It may also cause low levels of hemoglobin — which is found inside red blood cells — and platelets.
  • Biopsy: A bone marrow biopsy is the only way to confirm that leukemia cells are present in the bone marrow. There are two ways your doctor can obtain bone marrow, and some people will have both procedures during the same visit. You will be given either local anesthesia (to numb the biopsy site) or general anesthesia (which puts you to sleep for the procedure).
    • Bone marrow aspiration: The doctor uses a thick, hollow needle to remove samples of bone marrow.
    • Bone marrow biopsy: The doctor uses a very thick, hollow needle to remove a small piece of bone and bone marrow.
  • Chest x-ray: An x-ray can show swollen lymph nodes or other signs of disease in your chest.
  • CT scans: Sometimes additional CT (or PET or MRI) testing is needed to look for cancer in the liver, spleen, lymph nodes and other areas of the body, so the cancer can be treated appropriately.
  • Lumbar puncture: A spinal tap may be needed to find out whether leukemia cells are in the fluid around the brain. This is done only for specific blood cancers, or if there are symptoms suggesting that it may be necessary.

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