Diagnosing Leukemia

Leukemia isn’t just one disease. Instead, there are a number of different types that each require a specialized approach to treatment. It’s crucial to get the right diagnosis, right away.

At Siteman Cancer Center, our leukemia team will use advanced tests and imaging procedures to diagnose your leukemia correctly. Because our physicians specialize in leukemia, they are experts at identifying the disease.

Many patients travel great distances to be seen at Siteman, so we try to make your time with us as efficient as possible. You may be scheduled for multiple tests and appointments on the same day to spare you from having to make additional trips to our facility.

How is leukemia diagnosed?

If you are unwell with symptoms that could indicate leukemia, you will probably start by seeing your primary care provider. Your doctor will talk with you about your medical history and perform a physical exam to check for abnormalities, such as swollen lymph nodes or an enlarged spleen.

After conducting an exam, your doctor might ask you to undergo blood tests to look for evidence of leukemia.

If these tests suggest you may have leukemia, you will undergo more advanced tests. Patients are often referred for a bone marrow biopsy, a procedure in which bone marrow is collected from the hipbone so it can be examined for leukemia cells. You’ll be given local anesthesia to keep you comfortable. Your physicians may recommend a biopsy of one or more lymph nodes as well or imaging tests such as a PET and/or a CT scan to identify the extent of the leukemia and potential problem areas.

Second opinions from Siteman

Don’t be afraid to get a second opinion if you have been diagnosed with leukemia. Without it, you may not know what options you have. Our leukemia specialists can provide you with a second opinion to confirm your diagnosis, go through treatment options with you, put together a personalized treatment plan, and give you the peace of mind of knowing that you’ve made an informed decision about your treatment with some of the nation’s top leukemia experts.

Staging of leukemia

Unlike other cancers, leukemia typically is not assigned stages of I, II, III, and IV. Instead, your physicians will judge how active the disease is and assign it a status accordingly. The different statuses are:

  • Untreated
  • In remission
  • Recurrent


Your care team will estimate how your leukemia is likely to progress. This estimation is your prognosis, and it helps your physicians design an appropriate treatment plan for you. To determine your prognosis, your care team will consider a number of factors, including:

  • Whether the cancer is new or recurring
  • Your age and state of health
  • The extent of the leukemia in the body
  • Any genetic mutations, such as the Philadelphia chromosome