Chronic myelogenous leukemia laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

Characteristic complete blood count (CBC) features are as follows: absolute leukocytosis (median of 100,000/µL) with a left shift and classic “myelocyte bulge” (more myelocytes than the more mature metamyelocytes seen on the blood smear); blasts usually number <2%; absolute basophilia is nearly universal, with absolute eosinophilia in 90% of cases;¹¹ monocytosis is often seen, but generally not an increased monocyte percentage; absolute monocytosis is more prominent in the unusual cases with a p190 BCR-ABL;¹⁵ Platelet count is usually normal or elevated; thrombocytopenia suggests an alternative diagnosis or the presence of advanced stage, rather than chronic phase, disease.PMID:26434969

Tests and procedures used to diagnose chronic myelogenous leukemia include:

• Physical exam. Your doctor will examine you and check such vital signs as pulse and blood pressure. He or she will also feel your lymph nodes, spleen and abdomen for abnormalities.
• Blood tests. A complete blood count may reveal abnormalities in your blood cells. Blood chemistry tests to measure organ function may also reveal abnormalities that can help your doctor make a diagnosis.
• Bone marrow tests. Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for laboratory testing. These tests involve collecting bone marrow from your hipbone.
• Tests to look for the Philadelphia chromosome. Specialized tests, such as fluorescence in situ hybridization (FISH) analysis and the polymerase chain reaction (PCR) test, analyze blood or bone marrow samples for the presence of the Philadelphia chromosome or the BCR-ABL gene.

Laboratory Findings

low platelet count and/or platelet dysfunction

thrombocytosis and/or marked leukocytosis

elevated uric acid levels

marked leukocytosis or thrombocytosis

elevated histamine levels due to basophilia

Gallery

• 
  Blast crisis of chronic myelogenous leukemia (CML). Peripheral blood smear revealing the histopathologic features indicative of a blast crisis in the case of chronic myelogenous leukemia.
• 
  A photomicrograph of leukemia cells using Direct Fluorescent Antibody staining technique (DFA).

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