Tests That Help Evaluate CLL

Your doctor may request tests to learn more about your specific type of leukemia and to see if the leukemia is causing any other problems in your body. This will help your doctor decide on the most effective types of treatment for you. You may need one or more of these tests.

Chest X-Ray

A chest X-ray uses radiation to produce a picture of the organs and glands inside your chest. This test cannot show leukemia cells. But it can show if you have an infection in your lungs resulting from leukemia. It can also help your doctor see if lymph nodes in this area are swollen. The test takes only a few minutes, and it won't cause any pain.

Computed Tomography (CT) Scan

A CT scan takes X-ray pictures of different parts of your body from many different angles. Although this scan takes longer than an X-ray, it allows your doctor to get a better look at a particular area of your body than an X-ray allows. A CT scan can spot swollen lymph nodes and glands, pockets of infection in your organs, and large clusters of leukemia cells.

To have the test, you lie still on a table as it gradually slides through the center of the CT scanner. Then the scanner directs a continuous beam of painless X-rays at your body. A computer uses the data from the X-rays to create many pictures, which can be used to create a 3-dimensional picture. You may be asked to hold your breath one or more times during the scan.

In some cases, you will be asked to drink a contrast medium after an initial set of pictures is taken. This dye outlines your intestines so that they won't be mistaken for a tumor or a pocket of infection. The contrast will later pass through your system and exit through your bowel movements. If you receive it, instead, through an intravenous (IV) injection in your arm, this contrast dye may cause a feeling of warmth. In rare cases, it can also cause hives or other allergic reactions. Let your doctor know about any reactions you have or if you have had any reactions in the past.

Cytogenetics

The lab looks at the chromosomes of cells from samples of peripheral blood, bone marrow, or lymph nodes.

Newer Tests for CLL

Fluorescent in situ hybridization (FISH). FISH is a type of cytogenetic test that uses special fluorescent dyes that only attach to certain parts of certain chromosomes. It can be used to look for specific changes in chromosomes found in regular blood or bone marrow samples. The FISH test is very accurate, and is now used in many medical centers.

Flow Cytometry. Some doctors are now using flow cytometry (also called immunocytochemistry) to test blood for substances called ZAP-70 and CD38. These substances seem to be linked to what type of B lymphocyte is involved in the leukemia. Recent studies have suggested the CLL with fewer cells that express these substances may have a better outlook. These tests are still new and are not available in all labs.


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