Being diagnosed with CML

If your GP suspects you have CML, they will refer you to a haematologist. This is a doctor who specialises in diagnosing and treating blood problems. 

At the hospital

The haematologist will ask you about any illnesses or health problems you have had. They will examine you to check if your spleen is enlarged.

Blood tests

You will have blood tests at the hospital.

These tests are to:

  • check the number of blood cells in your blood (a full blood count)
  • look for leukaemia cells.

If the tests show there are leukaemia cells in your blood, the haematologist will arrange more tests. This is to find out the type of leukaemia you have and its extent. The results of these tests will help them plan your treatment.

Bone marrow sample

A doctor or nurse takes a small sample of bone marrow. They usually take it from the back of the hip bone (pelvis). Rarely, it is taken from the breast bone (sternum). The sample is sent to a laboratory to be checked for abnormal white blood cells.

A sample of bone marrow being taken from the back of the hip bone
A sample of bone marrow being taken from the back of the hip bone

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The procedure can be done on the ward or in the outpatient department. It takes about 20 to 30 minutes in total but removing the bone marrow sample only takes a few minutes.

Before the bone marrow sample is taken, you’ll be given a local anaesthetic injection to numb the area. You may also be offered a sedative to reduce any pain or discomfort during the test.

The doctor or nurse passes a needle through the skin into the bone. They then draw a small sample of liquid from inside the bone marrow into a syringe. This is called a bone marrow aspirate. It can feel uncomfortable for a few seconds when the liquid marrow is drawn into the syringe.

The doctor or nurse may also take a small core of bone. This contains the marrow and is called a trephine biopsy. They pass a thicker needle through the skin into the bone marrow. When they take the needle out, it contains a small core of bone marrow.

You may feel bruised after having a sample of bone marrow taken, and have an ache for a few days. This can be eased with mild painkillers.

I had to do a bone marrow test. It’s uncomfortable, but over in a flash.

Alan

Cytogenetic and molecular tests

Cytogenetic and molecular tests look at chromosomes. They might include the following two tests.

Philadelphia chromosome test

Doctors use the blood and bone marrow samples they have taken to look for the Philadelphia chromosome.

Polymerase chain reaction (PCR) test

This blood test looks for the BCR-ABL1 gene in the leukaemia cells. It is a very sensitive test, which can detect tiny amounts of leukaemia.

If you are diagnosed with CML, you will have regular PCR blood tests. Doctors use this test to check how well treatment is working.

Ultrasound scan

You might have an ultrasound scan to check the size of your spleen and liver. Ultrasound scans use sound-waves to build up a picture of the inside of the body. This is a painless test that only takes a few minutes.

Once you are lying comfortably on your back, the person doing the scan spreads a gel on the skin over the area they are scanning. Then they pass a small device that makes sound-waves over the area. A computer turns the sound-waves into a picture.

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