Diagnosing Leukemia: What Tests Should You Take?

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Get To Know Leukaemia

Leukaemia is a blood cancer that involves white blood cells growing uncontrollably in the human body. This cancer usually originates in the spine, sternum or pelvis, and can spread throughout the body via the bloodstream.

Leukaemia is a rare type of cancer in Malaysia, but it still poses a serious threat. Let's first learn about the different types of leukaemia before we get into the ways of detecting them.

Types of Leukaemia

In general, leukaemia is divided into two main types: acute lymphoblastic leukaemia (ALL) and acute myelogenous leukaemia (AML). Both types of cancer usually occur in children, while AML is more common in adults.

Other types include chronic lymphocytic leukaemia (CLL) and chronic myelogenous leukaemia (CML). Blood cancer can affect the circulatory system and potentially worsen in some people if not treated immediately.

How to Detect Leukaemia?

Diagnostic tests for leukaemia will involve several procedures to help doctors make an accurate diagnosis, such as:

1. Physical Examination

A physical examination is a test conducted by a doctor to detect any abnormal signs in the body. The doctor will examine all parts of the body including the skin, mouth, ears, nose, neck, armpits, breasts, abdomen, legs and pelvis.

The doctor will also examine the lymph nodes and organs such as the liver and spleen. This allows the doctor to determine whether there is any lymph node or organ enlargement.

2. Complete Blood Count

A complete blood count (CBC) is a test that measures the number of red blood cells, white blood cells and platelets in the blood. This test is important in detecting anaemia, leukopenia or thrombocytopenia.

Anaemia refers to a deficiency of red blood cells, leukopenia refers to a deficiency of white blood cells, while thrombocytopenia refers to a deficiency of platelets. This test can also show the presence of abnormal white blood cells or their increased quantity in the blood, which can indicate the possibility of leukaemia.

3. Blood Chemistry Test

A blood chemistry test determines the concentration of chemicals in the blood, such as proteins, enzymes and minerals. These chemicals' levels can indicate whether there is a problem with organs such as the liver or kidneys as a result of leukaemia. A blood chemistry test can also help assess the effectiveness of leukaemia treatment.

4. Cytokine Analysis

Cytokine analysis is a test used to determine the type of blood cells involved in cancer. This analysis employs the use of dyes to identify blood cells, as well as changes in their size and shape. The results of cytokine analysis assist doctors in differentiating between different types of leukaemia and selecting the best treatment for each patient.

5. Cytogenetic and Molecular Analysis

Cytogenetic and molecular analysis is a test that studies genetic changes and mutations in cancer cells using DNA technology. This test assists doctors in understanding the cause of leukaemia and identifying groups of patients who may respond better to certain treatments.

6. Bone Marrow Test

​A bone marrow test involves taking a sample of bone marrow from the back of the hip bone using a special needle. The sample is then tested to identify the type of blood cells and mutations associated with blood cancer.

This test helps doctors determine the stage and type of leukaemia experienced by a patient.

7. Lumbar Puncture

A lumbar puncture or cerebrospinal fluid test is a procedure that involves taking a small sample of the fluid that surrounds the brain and spinal cord. This test is performed to detect blood cancer that has spread to the central nervous system.

The doctor will use a special needle to take a small amount of fluid from the space between two lower bones of the spine. The fluid is then analysed to identify the type of blood cells and mutations associated with leukaemia.

8. Immunophenotyping

Immunophenotyping is a test that uses immunohistochemistry and cytometric analysis to confirm the presence of leukaemia.

• Immunohistochemistry

Immunohistochemistry is a chemical analysis method used to identify the type of cells in a blood sample. This test employs antibodies designed specifically to identify the type of cells present in the blood sample. Doctors can detect cancer cells in the blood using immunohistochemistry.

• Cytometric Analysis

Cytometric analysis is a test method used to measure and count cells in a blood sample. This test helps doctors identify the type of cells in the sample and confirm the presence of blood cancer cells. In addition, cytometric analysis can also help doctors determine the stage or grade of cancer.

9. Imaging Tests

Imaging test methods are used to confirm the type of leukaemia and the stage of the disease. Imaging test methods use equipment to create images of the internal human body. 

• X-Ray Scan

A chest X-ray scan is an imaging test used to detect the presence of blood cancer in the cartilage and spine. This test can help doctors determine the stage of the disease and choose the most appropriate treatment for the patient.

• CT Scan

CT scan or computerised tomography is an imaging method that uses X-rays to produce images of layers of organs in the patient's body. This test helps doctors identify the presence of cancer cells in organs such as the liver, spleen and pancreas.

• Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is a type of imaging that uses magnetic waves to create images of organs in the patient's body. This test can help doctors identify the presence of cancer cells in organs such as the brain, spine and nervous system.

10. Lymph Node Biopsy

A lymph node biopsy is a screening test that can be done to detect leukaemia. This test involves taking a tissue sample from a lymph node for analysis in the laboratory. If there are cancer cells in the tissue sample, it indicates the presence of leukaemia.

Although this test may not be as comfortable for the patient, it is a good way to find leukaemia at an early stage.

Where Can You Get Blood Cancer Screening?

​In Malaysia, blood cancer screening is available at both government and private clinics and hospitals. Government clinics and hospitals offer lower costs than private institutions.

Individuals who want to undergo blood cancer screening can refer to their family doctor for a referral to a suitable hospital or clinic. Individuals can also contact clinics and hospitals directly to make appointments and find out the cost of blood cancer screening.

How Much Does a Blood Cancer Screening Test Cost?

The cost of a blood cancer screening test depends on the medical institution conducting the test in Malaysia. The cost for routine blood tests is around RM50 to RM200, while tests such as biopsies may be higher, ranging from RM1,000 to RM5,000.

Individuals can also refer to government clinics that offer blood cancer screening tests for lower costs.

Early Detection Saves Lives!

Leukaemia can be a dangerous disease if not detected early. Therefore, blood cancer screening tests are important for detecting this disease and starting effective treatment immediately. Awareness of personal health and regular check-ups can help reduce the risk of blood cancer and improve quality of life.

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