Acute lymphoblastic leukemia other diagnostic studies
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Differentiating Acute lymphoblastic leukemia from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Cytogenetics
Cytogenetics (particularly the presence of Philadelphia chromosome) and immunophenotyping, establish whether the "blast" cells began from the B lymphocytes or T lymphocytes. DNA testing can establish how aggressive the disease is; different mutations have been associated with shorter or longer survival.
Biopsy
- A biopsy is the only sure way to know whether leukemia cells are in the bone marrow. Before the sample is taken, local anesthesia is used to numb the area. This helps reduce the pain. Bone marrow from your hipbone or another large bone is taken as biopsy.[1]
- A bone marrow biopsy and aspirate are routinely performed even in T-cell ALL to determine the extent of marrow involvement. Malignant cells should be sent for conventional cytogenetic studies, as detection of the Ph1 t(9;22), myc gene rearrangements (in Burkitt leukemia), and MLL gene rearrangements add important prognostic information[2]
Flow cytometry
- Flow cytometry should be performed to characterize expression of lineage-defining antigens and allow determination of the specific ALL subtype.[2]
References
- ↑ Harrison's Principles of Internal Medicine, 16th EditioN, Chapter 97. Malignancies of Lymphoid Cells. Clinical Features, Treatment, and Prognosis of Specific Lymphoid Malignancies.
- ↑ 2.0 2.1 "National Cancer Institute".