Leukocytes 227 x 10⁹/L are very likely to be leukemia, but the diagnosis of leukemia cannot be confirmed on the basis of one result of white blood cell count alone. 1. Leukemia can be manifested as a significant increase in the number of white blood cells and a large number of naïve cells, leukemia may also be manifested as a normal or reduced white blood cell count, so the white blood cell 227 × 10⁹ / L suggests that the likelihood of leukemia is very high, but can not be used as a basis for diagnosis. 2. Leukemia needs to be diagnosed according to clinical manifestations, blood and bone marrow images, etc. Clinical manifestations mainly include fever, anemia, infections, etc. Blood tests can show elevated white blood cell counts, primitive and naïve cells in blood smear, etc. Bone marrow images can show an increase in the number of primitive cells, etc., in which bone marrow images are the main basis for the diagnosis of leukemia and the mandatory tests. If the result of white blood cell examination is 227×10⁹/L, you should bring the result to the hospital in time for follow-up, and the doctor will make a comprehensive judgment of whether it is leukemia according to the results of various examinations and clinical manifestations.