Blood tests for leukemia include routine blood work, liver and kidney function, blood glucose, hepatitis B markers, blood type, transfusion necessity, and coagulation function.
Blood tests are most often done in leukemia, both before and after diagnosis, and should be reviewed regularly to understand the patient’s condition and as a basis for whether there is a relapse and the need for transfusion. Leukemia is divided into acute leukemia and chronic leukemia. In acute first-episode leukemia, the blood count is usually significantly higher, with an abnormal leukocyte classification and an increased proportion of lymphocytes or monocytes, accompanied by a decrease in red blood cells and platelets. In some patients, abnormal primitive cells are seen on peripheral blood smears. The presence of these conditions should be highly considered as a possibility of acute leukemia. A small number of patients with acute first-episode leukemia present with complete cytopenia. Patients with chronic leukemia usually have only abnormally high white blood cells in the early stages, usually without or with only mild anemia, and platelets are usually normal or elevated.
Patients with acute leukemia may have coagulation disorders at the onset. Therefore, coagulation testing is routinely done. The main treatment for acute leukemia is chemotherapy. Many patients need blood transfusions before and after chemotherapy, so they all need to be blood grouped and have pre-transfusion labs done. If patients have hepatitis B, they also need to have hepatitis B DNA testing. To avoid hepatitis B virus activation, chemotherapy is required for anti-hepatitis B virus treatment.
Biochemical tests such as liver and kidney function and blood glucose need to be checked before chemotherapy to help in the selection of chemotherapy drugs. The clinical diagnosis of leukemia requires a bone marrow aspiration to perform cytology, immunophenotyping, chromosomal, and fusion genes of the bone marrow in order to be able to do accurate typing of leukemia patients for prognostic stratification. All peripheral blood tests for leukemia can only be an adjunctive diagnosis, and only bone marrow tests can confirm the diagnosis.