Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of leukaemia, including:
- medical history and physical examination
- blood tests
- lumbar puncture (spinal tap) – where a sample of cerebrospinal fluid is taken to be examined under a microscope
- bone marrow aspiration and biopsy – where a sample of bone marrow and a small piece of bone are taken to be examined under a microscope
- medical imaging, which may include
- chest X-ray
- bone scan
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- positron emission tomography (PET) scan.
These tests are explained in more detail in How is cancer diagnosed?.
If your child is diagnosed with leukaemia, it is very important to accurately classify the cancer. This information is used to determine the precise therapy the child requires and estimate their outlook (prognosis).
Other childhood cancers use a process called staging to determine where the cancer is, how big it is, which nearby organs are involved and whether the cancer has spread to other parts of the body. Leukaemia is different, because the cancer starts in the bone marrow and spreads to the blood very quickly – this means that the leukaemia cells are already widespread throughout the body.
Your child will have tests (see How is cancer diagnosed?) to determine whether the leukaemia cells have built up in certain organs or areas of the body, such as the liver, spleen, lymph nodes or central nervous system. These diagnostic tests will also show the types and subtypes of cells that are involved in the leukaemia.
Your child’s doctor will also take into account whether the leukaemia is newly diagnosed, or whether it has been treated before but has come back (relapsed).