CONFIRMING DIAGNOSIS Typical clinical findings and bone marrow aspirate showing a proliferation of immature WBCs confirm acute leukemia.
A bone marrow biopsy, usually of the posterior superior iliac spine, is part of the diagnostic workup. Blood counts show thrombocytopenia and neutropenia. Differential leukocyte count determines cell type. Lumbar puncture detects meningeal involvement.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Chronic lymphocytic leukemia:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Typically, CLL is an incidental finding during a routine blood test that reveals numerous abnormal lymphocytes. In early stages, white blood cell (WBC) count is mildly but persistently elevated. Granulocytopenia is the rule, but the WBC count climbs as the disease progresses. Blood studies also show hemoglobin levels under 11 g, hypogammaglobulinemia, and depressed serum globulins. Other common developments include neutropenia (neutrophils less than 1,500/µl), lymphocytosis (lymphocytes more than 10,000/µl), and thrombocytopenia (platelets less than 150,000/µl). Bone marrow aspiration and biopsy show lymphocytic invasion.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Leukemia, acute:
Diagnosis
(Handbook of Diseases)
Typical signs and symptoms and bone marrow aspirate showing a proliferation of immature WBCs confirm acute leukemia. An aspirate that’s dry or free from leukemic cells in a patient with typical signs and symptoms requires a bone marrow biopsy, usually of the posterior superior iliac spine.
Blood counts show thrombocytopenia and neutropenia. A differential leukocyte count determines cell type. Lumbar puncture detects meningeal involvement.
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Source: Handbook of Diseases, 2003
Leukemia, chronic lymphocytic:
Diagnosis
(Handbook of Diseases)
Typically, chronic lymphocytic leukemia is an incidental finding during a routine blood test that reveals numerous abnormal lymphocytes. In early stages, the white blood cell (WBC) count is mildly but persistently elevated. Granulocytopenia is the rule, but the WBC count climbs as the disease progresses.
Blood studies also show a hemoglobin level below 11 g, hypogammaglobulinemia, and depressed serum globulin levels. Other common findings include neutropenia (less than 1,500/µl), lymphocytosis (more than 10,000/µl), and thrombocytopenia (less than 150,000/µl). Bone marrow aspiration and biopsy show lymphocytic invasion.
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Source: Handbook of Diseases, 2003
Leukemia, chronic granulocytic:
Diagnosis
(Handbook of Diseases)
In patients with typical signs and symptoms, chromosomal analysis of peripheral blood or bone marrow showing Ph1 and low leukocyte alkaline phosphatase levels confirms CGL. Other relevant laboratory results include:
❑ white blood cell abnormalities: leukocytosis (leukocyte count ranging from 50,000/µl to 250,000/µl), occasional leukopenia (leukocyte count less than 5,000/µl), neutropenia (neutrophil count less than 1,500/µl) despite a high leukocyte count, and increased circulating myeloblasts
❑ hemoglobin level: commonly below 10 g/dl
❑ hematocrit: low (less than 30%)
❑ platelet count: thrombocytosis (more than 1 million/µl) common
❑ serum uric acid level: possibly more than 8 mg/dl
❑ bone marrow aspirate or biopsy: hypercellular, characteristically shows bone marrow infiltration by significantly increased number of myeloid elements (a biopsy is done only if aspirate is dry); in the acute phase, myeloblasts predominate
❑ computed tomography scan: may identify the organs affected by leukemia.
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Source: Handbook of Diseases, 2003
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