Diagnostic of Acute Lymphoblastic Leukemia (all)

Acute lymphoblastic leukemia is a serious disease of the hematological system, which most often affects children under 5 years old. The second peak in the incidence rate occurs after 50 years. About 40% of patients are adults. Although the disease affects mainly children, they can be often completely cured. 80% of deaths from lymphoblastic leukemia are in adults.

Symptoms

The disease does not have specific symptoms. Acute lymphoblastic leukemia leads to the following conditions:

• general intoxication of the body (weakness, fever, fatigue);
• anemia (pale skin, increased heart rate, shortness of breath);
• blood-clotting disorders (nasal hemorrhage, prolonged hemorrhage from the slightest scratches, bruises on the body for no reasons).

All patients have reduced immunity due to a decrease in the number of normal white blood cells. Although their total number is large, it is mainly lymphoblasts that are not able to perform their function.

Diagnosis confirmation 

Early diagnostics is complicated due to the absence of specific symptoms. Therefore, if any of the manifestations listed above appear, you should visit a doctor, undergo an examination and blood test. The doctor will analyze the patient's medical history, look at the data from previous tests, perform an examination and prescribe the necessary tests.

Only one complete blood count often allows the doctor to detect leukemia in a child. The number of erythrocytes and platelets in the blood is reduced. The doctor can detect many immature white blood cells, called lymphoblasts. These are precursor cells, which are normally detected only in the red bone marrow. They should not be in the blood at all. They are immature and cannot function as normal white blood cells.

However, the complete blood count is not sufficient to confirm the diagnosis. It is necessary to carry out the aspiration and biopsy of the red bone marrow. Both types of tests can be taken simultaneously.

At first, the doctor carries out aspiration. For this purpose, he uses an aspirator – a syringe with a thin needle. He inserts it into the pelvic bone and using negative pressure extracts a small amount of red bone marrow. The second stage is the biopsy. The doctor uses a thicker needle. It allows him to obtain a column of tissue, which is sent for histological examination.

The doctors perform the following test with these samples:

• examination under the microscope;
• cytochemical analysis;
• immunohistochemical examination;
• immunophenotyping;
• cytogenetic tests, fluorescence in situ hybridization, and PCR for detection of chromosomal and genetic abnormalities.

The diagnosis can be determined after microscopy. The criterion for leukemia is the detection of blast cells in the red bone marrow in an amount of more than 20%. Normally, they should be less than 5%. The further examinations can be required only to clarify the diagnosis. The subtype of leukemia, genetic and other changes are prognostic factors and allow to carry out a better planning of treatment for the child.

A bone marrow biopsy is performed repeatedly during the treatment process. The analysis is used to assess its results, detect a relapse, determine the optimal treatment options.

Additional examinations

Occasionally, lumbar puncture can be carried out as well. It can be required in the case of signs of the spread of lymphoblastic leukemia to the organs of the central nervous system. The needle is inserted into the space between the lumbar vertebrae and cerebrospinal fluid is extracted for analysis.

A sentinel lymph node biopsy can be required in rare cases. It serves for the differential diagnostics of acute lymphoblastic leukemia and lymphoma. As a rule, the entire node is removed and sent for histological examination.

Medical imaging tests are not performed at all or have limited diagnostic value. As a rule, the doctors use the following examination techniques:

• chest x-ray – to detect signs of infectious processes in the lungs, which often occur due to the decrease in immunity;
• CT – allows the doctor to detect enlarged lymph nodes or tumor foci in the spleen;
• MRI – can be prescribed for the detection of malignant cells in the cerebrospinal fluid after lumbar puncture;
• Ultrasound examination – can detect enlarged liver, spleen, lesion of the kidneys or testicles.

The protocol does not require medical imaging tests for all patients. These methods can be used only according to the indications.

Diagnostics in the best hospitals in the world with the Booking Health company

To undergo the diagnostics or treatment of acute lymphoblastic leukemia abroad, please contact the Booking Health company for assistance. We will arrange a trip abroad for you. The cooperation with us will be beneficial for you for a number of the following reasons:

• Opportunity to undergo the diagnostics and treatment of acute lymphoblastic leukemia in children in the world's best Cancer Centers. We will select the medical facility according to the field of its practical activities and scientific interests, taking into account statistics on acute lymphocytic leukemia.
• Reduced costs for the diagnostics and treatment of acute lymphoblastic leukemia abroad due to the absence of overpricing and additional coefficients for foreign patients.
• Booking an appointment on the most suitable dates for you, reduced waiting time for the beginning of the diagnostics and treatment.
• Preparation of the diagnostic program according to the modern protocol, taking into account previously performed examinations.
• Establishment of communication directly with the attending physician.
• Monitoring of the treatment program for acute lymphoblastic leukemia at all its stages.
• Control of invoices and return of unspent funds.
• Buying and forwarding of medicines.
• Organization of additional diagnostic or therapeutic procedures.
• Communication with the clinic upon completion of treatment of acute lymphoblastic leukemia in children.

The Booking Health company will provide you with high-quality services. We will book a hotel and airline tickets for you, meet you at the airport and take you to the clinic by car.