Acute lymphoblastic leukemia is a cancer that affects the white blood cells in a person’s blood and bone marrow. Doctors will consider physical symptoms and use blood tests and bone marrow tests to further diagnose the cancer.

Leukemia is a type of cancer that affects the blood-forming cells in a person’s body. Acute lymphoblastic leukemia (ALL), also known as acute lymphocytic leukemia, is a fast-progressing disease that needs quick diagnosis and treatment.

According to the American Cancer Society (ACS), ALL makes up less than 1% of all cancers diagnosed in the United States. There are no early screening tests available to identify ALL.

However, if a person displays the physical symptoms associated with ALL, a doctor can use blood tests and bone marrow tests to complete a diagnosis. They may also use further tests to learn the extent of ALL in the body.

This article explains the main types of tests doctors use to diagnose ALL and what each test looks for, as well as the symptoms and prevalence of the disease.

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The first step in an ALL diagnosis usually starts with a physical check. Before anything else, a doctor will consider a person’s medical history and physical symptoms to rule out other potential issues.

The doctor may check for bruises, bleeding, swollen lymph nodes, and more. They may also ask about other symptoms, such as fatigue.

After a physical exam, the doctor may take a blood sample to check a person’s blood cells and blood chemistry. Some of the ways a doctor will test a person’s blood include:

  • Complete blood count: This measures the type of blood cells and how many of each are present.
  • Peripheral blood smear: This checks the shape, size, and number of each blood cell type, including any immature blood cells.
  • Blood chemistry test: This measures certain substances released by a person’s organs in their blood.

Blood tests help doctors look for abnormalities that could indicate leukemia. If a person’s blood sample has high levels of abnormal white blood cells, a doctor may refer them to a specialist for further testing.

A doctor usually takes this sample from the hip bone or breastbone using a needle. The doctor will numb the area before taking their sample. However, some people may experience bruising and pain once the anesthetic wears off.

Doctors may test bone marrow in the following ways:

  • Cytogenetic analysis: A doctor looks at the genetic structure of cells to find changes that could indicate cancer.
  • Immunophenotyping: This test uses antibodies to help a doctor identify the specific type of leukemia a person may have.

Individuals diagnosed with ALL may need bone marrow tests as often as every 3 months during treatment.

Learn more about bone marrow biopsies.

Doctors can usually diagnose ALL using blood tests and bone marrow tests. However, after diagnosis, a person may need further tests to determine how far the cancer has spread through their body.

According to the National Cancer Institute (NCI), these tests can include:

These tests allow a doctor to check that the leukemia has not spread to the brain, spine, and other vital internal organs. Understanding how far the cells have spread helps doctors plan the best course of treatment.

Screenings and tests are available to identify some types of cancer early. However, there are currently no such tests for detecting ALL in the earliest stages.

Instead, doctors will perform blood and bone marrow tests if a person shows symptoms of ALL, particularly if they are at higher risk of leukemia.

Genetic syndromes, such as Down syndrome, and experiencing previous medical treatments, including chemotherapy drugs and radiation, are associated with a higher risk of developing ALL.

A doctor may test someone for signs of leukemia if they show the following symptoms:

If a person notices any of the above symptoms, they may wish to speak with a doctor to isolate the cause.

The ACS states the following statistics for the prevalence of ALL in adults and children in the United States in 2023:

New cases6,540

ALL is the most common form of leukemia diagnosed in children, making up 80% of cases, as opposed to 20% in adults.

People with certain genetic syndromes or previous exposure to chemotherapy and radiation may also be at a higher risk of developing ALL.

However, the ACS estimates the average person’s risk of developing ALL is 1 in 1,000.

ALL is a blood and bone marrow cancer that affects a person’s white blood cells. This disease progresses quickly, so the speed of diagnosis is important.

If a person displays symptoms associated with leukemia, doctors will use blood and bone marrow tests to gather more information and diagnose the specific type of leukemia they may have.

Following an official diagnosis, a person may undergo further tests to learn the extent of ALL in their body. These tests will help a doctor decide on the best course of treatment.