Acute lymphoblastic leukaemia

Children suspected of having leukaemia based on symptoms and signs found during clinical examination need to have some tests, including the following:

• Complete blood test.
• A bone marrow study made by a biopsy and an aspirate. In this test, a doctor will take a sample of cells from the bone marrow.

Doctors will perform different tests to blood and bone marrow samples to search for leukaemia cells. Evaluating the form they have and finding some specific characteristics (called biomarkers) will allow them to classify the leukemia cells into B or T.

The diagnosis of ALL is established by:

• The characteristic morphology (form) of leukaemia cells (lymphoblasts) found in the blood, bone marrow, lymph node, and/or other involved tissues.
• The diagnostic immunophenotype: this means that doctors asses or get to know what characteristic or biomarker these leukaemia cells have and can classify them according on their lineage (B, T or bipenotipe)
• The genomics of childhood ALL has been extensively investigated, and multiple distinctive subtypes have been defined on the basis of cytogenetic and molecular characterizations, each with its own pattern of clinical and prognostic characteristics.

Other tests needed:

Once diagnosed with ALL and before starting the treatment, children must undergo additional tests like:

• Blood test with coagulation test: to see whether the child's blood tends to cause blood clots to estimate potential complications in kidney and liver function.

• Lumbar puncture: this test allows the doctor to see if the leukaemic cells have reached the central nervous system (CNS).
• Chest X-ray or CT to check if there is any mass in the mediastine (the central part of the chest).
• Echocardiogram or cardiac scan to verify that the heart works correctly.
• Doctors should also make sure children have no infections before beginning therapy.

Check out further resources and websites for more information on this: