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Investigations in ALL

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Laboratory finding in ALL include:

  • complete blood count with differential
    • severe anaemia (Hb < 8 g/dl) - seen in around 28%
    • severe granulocytopenia (neutrophils <0.5 × 10^9/l) - in 22%
    • severe thrombocytopenia (platelets <25 × 10^9/l) - in 30%
    • hyperleukocytosis - total white blood cells >10 ×10^9/l - in 59%, and >50 × 10^9/l in 28%
      • detectable circulating blast cells in 92% of cases
  • renal function
    • hyperuricaemia
  • clotting tests and fibrinogen concentration - to screen for disseminated intravascular coagulation.
  • LDH levels - usually elevated
  • screen for evidence of active infection (1,2).

Bone marrow biopsy and aspirate for:

  • cytogenetic analysis
  • immunophenotyping - it is important to differentiate between T-cell, mature B-cell and B-cell precursor phenotypes for therapeutic purposes (3)

Reference:

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