How CLL is diagnosed

Your GP will examine you and take a blood test. If the blood test shows abnormal levels of blood cells, your GP will then refer you to a hospital specialist, called a haematologist, for specialist advice and treatment.

The doctor at the hospital will ask you about your full medical history and do a physical examination to check for any enlargement of the lymph nodes, spleen or liver. You will also have further blood tests to examine the levels of particular blood cells in more detail. If your blood tests show leukaemia cells, you may need to have a bone marrow test to be sure of the diagnosis and to help with planning the best treatment for you.

Bone marrow test

A small sample (biopsy) of bone marrow is taken from the hipbone (pelvis) or the breastbone (sternum), and looked at under the microscope to see if it contains any abnormal white blood cells. The doctor will be able to tell which type of leukaemia it is by identifying the type of abnormal white cell.

The bone marrow sample is taken under a local anaesthetic. You are given an injection to numb the area and a needle is pushed gently through the skin into the bone. A sample of the marrow is then drawn into a syringe. Usually a small core of marrow is needed (a trephine biopsy) and this takes a few minutes. The test can be done on the ward, or in the outpatients department. The procedure can be painful, but only takes about 15 minutes. You may be given a mild sedative to reduce any pain or discomfort during the test.

A sample of bone marrow is usually taken from the back of the hipbone

If you have had a sedative, you will not be able to drive, so it is best to have a friend or relative with you to take you home. When the local anaesthetic wears off, you will feel an ache that can last for a few days. You can take mild painkillers if you need to.