Leukemia Health (cont.)
Wendy Hu, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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Because the symptoms of leukemia are nonspecific and the causes are not clearly defined, one's health care professional will carry out extensive interviews and any appropriate tests in order to identify the underlying cause.
Blood tests: Blood is drawn from a vein in order to check the blood cell counts. In most cases of leukemia, the white blood cell count is very high (although it is not uncommon for the white cell count to be normal in many of the childhood acute lymphocytic leukemias) and the platelet and red cell counts are low. This makes the health care professional consider leukemia as the diagnosis. Other tests are performed to check liver and kidney functions and the possible presence of leukemic cells in the spinal fluid.
Biopsy: Because other conditions may give rise to atypical white cell counts, the only way to confirm the diagnosis of leukemia is via an aspirate and biopsy of the bone marrow.
Genetic studies: The chromosomes of the abnormal cells are examined to look for irregularities. This helps in classifying the various types of leukemia.
Lumbar puncture (spinal tap): Because the collection of leukemia cells in the central nervous system can affect mental processes, it is extremely important to know whether the fluid surrounding the brain and spinal cord (cerebrospinal fluid) is affected.
Lymph node excision: If the lymph nodes are enlarged, a node may require a biopsy if the bone marrow is difficult to interpret for some obscure reason. This is exceedingly uncommon.
Chest X-ray: A chest X-ray is frequently taken to look for signs of infection or lymph node involvement by leukemia.
Staging is the way cancers are classified. Staging indicates the size or extent of spread of the cancer, the degree to which other parts of the body are affected, and other important details. In general, leukemias are classified rather than staged in order to determine the most appropriate therapy.
All leukemias are classified according to their genotypes, or their unique chromosomal arrangements, which also enables the physicians to determine risk factors.
In addiction, chronic myelogenous leukemia is classified by phase. The three phases are chronic phase, accelerated phase, and blast phase (or "blast crisis") and are defined by the number of blasts (immature leukemia cells) in the blood and bone marrow.
Chronic lymphocytic leukemia is classified by two different staging systems, both based on the parts of the body affected by the leukemia.
Reviewed by Melissa Conrad Stöppler, MD on 8/13/2012
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