Diagnosis

Most cases of chronic lymphocytic leukaemia (CLL)are detected during blood tests carried out for another reason.

However, you should visit your GP if you have worrying Leukaemia, chronic lymphocytic , such aspersistent tiredness, unusual bleeding or bruising, unexplained weight loss or night sweats .

Your GP may:

• ask about your symptoms and your medical and family history
• carry out a physical examination to check for problems such as swollen glands and a swollen spleen
• send off a bloodsample for testing

Ifyour GPthinks you could have CLL, you'll be referred to a hospital doctor called a haematologist, a specialist in blood disorders, for further tests.

Some of the tests you might have are outlined below.

Blood tests

The main test used to help diagnose CLL is a type of blood test called a full blood count .

This is where the number and appearance of the different blood cells in a sample of your blood are checked in a laboratory.

An abnormally high number of unusual white blood cells(lymphocytes) can be a sign ofCLL. A detailed examination of these cells can usually confirm the diagnosis.

X-rays and scans

You may also have:

• a chest X-ray
• an ultrasound scan of your tummy
• a computerised tomography (CT) scan

These tests can check for problems caused by CLL, such as swollen glandsora swollenspleen,and helprule out other possible causes of your symptoms.

Bone marrow biopsy

Sometimesthehaematologistmayrecommend removing a sample of your bone marrow(bone marrow biopsy) so they canexamine itunder a microscope to check it for cancerous cells.

The sample is removedusinga needle inserted into your hip bone. Local anaesthetic is normally used tonumb the area where the needle is inserted, although you may experience some discomfort during the biopsy.

The procedure willlast around 15 minutes and you shouldn't need to stay in hospital overnight. You mayhave some bruising and discomfort for a few days afterwards.

Lymph node biopsy

In some cases, removing and examining a swollen lymph gland can help confirm a diagnosis of CLL. This is known as a lymph node biopsy.

The gland is removed during a minor operation carried out under either local or general anaesthetic , where you're asleep. You won't usually need to stay in hospital overnight.

After the operation, you'll be left with a small wound that will be closed with stitches.

Genetic tests

Tests may also be carried out on your blood and bone marrow samples to check for any unusual genes in the cancerous cells.

Identifying unusual genes in these cells can help your doctors decide how soon you should start treatment and which treatment is best for you.

Some treatments for CLL don't work as well in people with certain abnormal genes in the affected cells.