Tests for chronic lymphocytic leukaemia (CLL)
The following tests help the doctors find out what type of leukaemia you have and the extent of it.
Tests carried out on your blood may include:
Immunophenotyping - shows which types of white blood cells are abnormal.
Cytogenetic testing - looks at the chromosomes in the leukaemia cells. Chromosomes are made up of genes and control the activity of the cell. There are often changes (mutations) in the chromosomes of CLL cells. A test called fluorescent in situ hybridisation (FISH) is sometimes used to look for any cytogenetic changes. Knowing what these changes are helps doctors to understand how the CLL may behave and to plan your treatment.
Antibody testing - checks the levels of antibodies you have in your blood for fighting infection. CLL cells may also make antibodies that damage your red blood cells. A blood test may be done to check for them.
This uses x-rays to take a picture of your chest, to check your lungs and heart. The x-ray will also look at lymph nodes in your chest.
CT (computerised tomography) scan
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This is sometimes done to check how many lymph nodes are affected by CLL and to see whether the spleen is enlarged.
A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan takes 10-30 minutes and is painless. You’ll probably be able to go home as soon as the scan is over.
This test isn’t usually needed, but some people may have an enlarged lymph node removed so it can be examined under a microscope. This may be done under a local or general anaesthetic. It’s a small operation, during which the node is removed and sent to the laboratory. Most people can go home on the same day. After the operation, you’ll have a small wound with a few stitches. The stitches are usually taken out after about 7-10 days.
Some people may have this test to check how much CLL is in their bone marrow. A small sample (biopsy) of bone marrow is taken from the hip bone. This is usually done under a local anaesthetic in the outpatient department and takes about 10 minutes. It can feel quite uncomfortable but you can take painkillers if you need to.
Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse or one of the organisations listed on our database, can also provide support. You can also talk things over with one of our cancer support specialists.
How CLL may behave (prognosis)
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CLL can behave very differently in different people. Often it develops slowly over many years - sometimes 20 or more. However, in some people CLL develops more quickly. Doctors may use cytogenetic tests to help plan treatment.
Cytogenetic tests look for any abnormal changes in the chromosomes of a cell.
Between 30-50% of people (3-5 out of 10) with CLL have a cytogenetic change called del (13q) in the leukaemia cells. People with this change alone often have a type of CLL that develops extremely slowly and doesn’t need any treatment for many years.
Fewer than 10% of people (1 out of 10) have a cytogenetic change called del (17p). This makes the leukaemia more difficult to control. CLL with this change sometimes needs different treatment from other types of CLL.
About 40-60% of people (4-6 out of 10) either have other cytogenetic changes in their CLL cells, or none at all. The leukaemia often needs treatment, but usually not immediately, and can be controlled for a number of years with treatment.