If you suspect that you got leukemia, these checking you may need
1. Blood biochemistry
Particularly in chemotherapy, serum uric acid concentrations
increased. Urinary uric acid excretion increased, even uric acid
crystals. Occurs in patients with DIC can occur when the clotting
mechanism. Acute monocytic leukemia in serum and urine lysozyme
activity increased, acute myeloid leukemia is not increased, while
acute lymphocytic leukemia, often reduced. Central nervous system
leukemia occurs when the fluid pressure increased, the number of white
blood cells increased (>; 0.01 × 109 / L), increased protein (>;
450mg / L). Quantitative reduction of sugar. Smears can be found in
leukemia cells. Voicing degree of cerebrospinal fluid contains cells
with vary.
2. Granulocyte - a single progenitor cells (CFU-GM) semi-solid culture
ANLL marrow CFU-GM colony does not produce or generate very
little, while the increase in the number of clustered; remission colony
to resume growth, and also reducing the recurrence of the former
colony.
3. Chromosome and gene changes
Leukemia, often accompanied by specific changes in chromosomes and
genes. For example, M3t (15; 17) (q22; q21) on chromosome 15, the
Department of PML (promyelocytic leukemia) and on chromosome 17 RARa
(Victoria A acid receptor genes) and the formation of PML / RARa fusion
gene. This is the M3 the disease and effective treatment with
acid-dimensional A molecular genetic. In addition, certain of acute
leukemia, there are N-ras oncogene point mutations and activation.
Tumor-suppressor gene P53, Rb inactivation.
4. Immunological tests
According to leukemia cell-mediated immunity markers, not only can
be poured with ANLL acute differences; and may be T cells and B-cell
Acute Lymphoblastic Leukemia to be distinguished. Monoclonal antibodies
can also be divided into several subtypes of Acute Lymphoblastic
Leukemia.
5. Bone marrow puncture
Most cases of bone marrow nucleated cells were significantly
increased, mainly leukemia primitive cells, accounting for the
non-erythroid cells in more than 30%, while the more mature cells,
absence of intermediate stage, and a small amount of residual mature
granulocytes, forming so-called "hole" phenomenon. Normal young red
blood cells and giant nuclear cells decreased. About 10% of ANLL
myeloproliferative low as hypoplastic acute leukemia. Although the bone
marrow nucleated cell proliferation is low, but still accounts for the
non-leukemic cells, primitive erythroid cells, over 30%. Primitive
leukemia often have abnormal changes in cell morphology, such as the
cell body larger increase in the proportion of nucleus and cytoplasm,
the nuclear shape abnormalities (eg, notch, depression, sub-leaf,
etc.), chromatin coarse, irregularly arranged, prominent nucleoli and
so on. Auer body more commonly found in acute myeloid leukemia cells in
plasma in acute monocytic leukemia and acute myeloid - monocytic
leukemia cells, plasma can also be seen sometimes, but does not appear
in Acute Lymphoblastic Leukemia. Auer body and therefore help to
identify acute lymphocytic and ANLL.
6. Routine blood test
An increase in white blood cell count in most patients, disease,
increased more significantly late. To the highest bidder of more than
100 × 109 / L, known as a high white blood cell leukemia. There are
also many patients with white blood cell count at normal levels or
reduced, and lower can <; 1.0 × 109 / L, known as the white blood
cells did not increase in leukemia. Blood film classification check
original and (or) naive cells, usually accounts for 30% ~ 90%, or even
as high as 95% or more, but not an increase in white blood cell type is
difficult to find cases of blood spots on the original cell. Leukemia
patients have varying degrees of normal cell anemia, a small number of
patients with blood spots on the red blood cell size, can be found in
immature red blood cells. About 50% of patients platelets less than 60
× 109 / L, platelets are often very reduced late.