Investigations In Leukemia

Investigations In Leukemia

Question. Write a short note on investigations in leukemia.
Answer. Leukemias are a group of disorders characterized by malignant transformation of blood-forming cells.

Investigations in Acute Leukemia

Blood Picture

• Anemia: It is almost always seen in all types of leukemia. It is severe, progressive, and normochromic in type. Few nucleated RBCs can also be seen.
• Thrombocytopenia: It is moderately to severely decreased, i.e., less than 50,000/µL.
• White blood cells: Total WBC count ranges from subnormal to markedly elevated values. In 25% of patients, total WBC count is reduced from 1000 to 4000/µL, and it exceeds 100,000/µL in advanced cases. The majority of leukocytes in peripheral blood are blasts, and neutropenia is seen due to infiltration by leukemic cells.
• In myeloid leukemia, prominent cells often resemble myeloblasts or undifferentiated myelocytes.

Complete blood count in leukemia

Other Blood Investigations

Bleeding time and clotting time are increased.

Platelet count in leukemia patients

Bone Marrow Examination

Examination of bone marrow aspirate reveals

• Cellularity: Marrow is hypercellular
• Leukemic cells: About 20% of leukemic blast cells are seen in the examination.
• Erythropoiesis: Erythropoietic cells are reduced. Megaloblastic features and ring sideroblasts are seen.
• Megakaryocytes: They are either reduced or absent.

Investigations in leukemia

Serum Uric Acid

It gets reduced.

Investigations in Chronic Myeloid Leukemia

Chronic Myeloid Leukemia Blood Picture

• Anemia: It is usually of moderate degree and is normocytic normochromic in type.
• White blood cells: Marked leukocytosis is seen. Over 500,000 cells per cubic mm are seen.
• Platelets: Platelet count may be normal or raised.

Chronic Myeloid Leukemia Bone Marrow Examination

• Cellularity: Hypercellularity is seen.
• Myeloid Cells: Myeloid cells predominate in bone marrow.
• Erythropoiesis: It is normoblastic, but a reduction in erythropoietic cells is seen.
• Megakaryocytes: They are smaller in size than normal.

Cytogenetic analysis in leukemia

Investigations in Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia Blood Picture

• Anemia: It is usually of a mild-to-moderate degree and is normocytic normochromic in type.
• White blood cells: Marked leukocytosis is seen. Over 500,000 cells per cubic mm are seen.
• Platelets: Platelet count may be normal or moderately reduced.

Chronic Lymphocytic Leukemia Bone Marrow Examination

• Increased lymphocyte count is seen
• Reduced myeloid precursors
• Reduced erythroid precursors.