Which tests and studies are performed in the evaluation of acute lymphoblastic leukemia (ALL)?

Updated: Jul 02, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Laboratory tests and other studies used in the workup for ALL include the following:

  • Complete blood count with differential
  • Coagulation studies, including PT, PTT, fibrinogen and fibrin split products
  • Peripheral blood smear
  • Chemistry profile, including lactate dehydrogenase, uric acid, liver function studies, and BUN/creatinine
  • Appropriate cultures (in particular, blood cultures) in patients with fever or other signs of infection
  • Chest x-ray
  • Computed tomography, as indicated by symptoms
  • Multiple-gated acquisition scanning or echocardiogram
  • Electrocardiography
  • Lumbar puncture (especially in children)
  • Bone marrow aspiration and biopsy (definitive for confirming leukemia)

Bone marrow studies should include the following:

  • Histology
  • Immunohistochemistry/flow cytometry
  • Cytogenetics
  • Fluorescence in situ hybridization
  • Polymerase chain reaction
  • Next-generation sequencing

See Workup for more detail.

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