What tests are used to diagnose CLL?

CLL is usually found by using more than one test, including any or all of the following.

Physical exam

The doctor will check for swollen glands or lymph nodes.

Blood tests

A blood test shows the number of healthy white blood cells (lymphocytes) and unhealthy CLL cells. It also checks for the number of red blood cells and platelets. This is done by looking at blood cells under a microscope.

Aspiration/biopsy

Your doctor may take out a small sample of bone marrow from the back of the hip bone. This will help show the doctor how advanced the disease is.

Flow cytometry

This test looks for certain substances that are found on CLL cells. This helps identify what types of cells they are and determine if the CLL cells will respond to certain types of treatment. That information helps the doctor understand how the disease might progress, and whether the high lymphocyte count is caused by CLL.

Lab testing

Certain lab tests look at the DNA of blood cells under a microscope. Differences in the DNA can be seen by using a dye that shines under a certain light. Very often, some DNA is missing from CLL cells. The kind of DNA that is still there will give the doctor information he/she needs to know to help make treatment decisions.

Imaging

Imaging tests, such as CT scans and MRI, are used to see how much the disease has spread.

How do I know if I have early or advanced CLL?

The testing your doctor does will help identify the stage of your cancer. The stage means how far the cancer has spread or progressed. For CLL, there are 2 ways to figure out the stage. In the United States, doctors use what is called Rai staging. Rai staging is based on the blood cell count and whether the lymph nodes and/or other tissues in the body are affected. The risk groups are used to help your doctor determine your treatment options.

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