Leukemia

Leukemia Lab Tests and health information

Order your leukemia tests to screen for abnormal levels of red or white blood cells or platelets — which may suggest leukemia and may also show the presence of leukemia cells. Take control of your health and get tested with Ulta Lab Tests.


Name Matches

Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

  • Reticulocytes
  • Iron and Total Iron Binding Capacity
  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Epstein-Barr Virus
  • Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Description: A Complete Blood Count or CBC (H/H, RBC, Indices, WBC, Plt) test is a blood test that measures many important features of your blood and counts your red blood cells, white blood cells, and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen.

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with White Blood Cell Count and Platelets Test, Hemogram Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a CBC test ordered?

The complete blood count is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary.

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding.

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working.

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis.

What does a CBC blood test check for?

The complete blood count is a blood test that determines the number of cells in circulation. White blood cells, red blood cells, and platelets are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances.

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. The following items are included in a conventional CBC:

  • White blood cell count.
  • RBC count, hemoglobin, hematocrit, and RBC indicators such as mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width are all used to assess red blood cells. The reticulocyte count may or may not be included in the RBC evaluation.
  • Platelet count; may or may not include mean platelet volume and platelet distribution width in platelet evaluation

The CBC focuses on three different types of cells:

White Blood Cells

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more in order to combat bacterial infection. The amount of white blood cells in the body may increase as a result of allergies. A viral infection may cause an increase in white blood cell production. Abnormal white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count.

Red Blood Cells

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity.

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood, and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood. This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances.

Platelets

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC.

Lab tests often ordered with a CBC test:

  • Reticulocytes
  • Iron and Total Iron Binding Capacity
  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Epstein-Barr Virus
  • Von Willebrand Factor Antigen

Conditions where a CBC test is recommended:

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions:

How does my health care provider use a CBC test?

The complete blood count is a common, comprehensive screening test used to measure a person's overall health status. It can be used for a variety of purposes, including:

  • To check for a variety of ailments and disorders.
  • Assist in the diagnosis of a variety of illnesses, including anemia, infection, inflammation, bleeding disorders, and leukemia, to mention a few.
  • After a diagnosis has been made, keep an eye on the patient's condition and/or the treatment's effectiveness.
  • Treatments that are known to influence blood cells, such as chemotherapy or radiation therapy, should be monitored.

A complete blood count is a set of tests that assesses the three types of cells that circulate in the bloodstream. The following items are included in a CBC:

White blood cells, which are part of the body's defensive system against infections and cancer, as well as playing a role in allergies and inflammation, are assessed:

  • The total number of white blood cells in a person's blood sample is measured by a white blood cell count.

Red blood cells, which transport oxygen throughout the body, are assessed as follows:

  • The quantity of red blood cells in a person's blood sample is measured by a red blood cell count.
  • The overall amount of oxygen-carrying protein in the blood is measured by hemoglobin, which generally indicates the number of red blood cells in the blood.
  • Hematocrit is a measurement of how many red blood cells make up a person's total blood volume.
  • RBC indices are calculations that give information about the physical features of RBCs:
  • The average size of a single red blood cell is measured by the mean corpuscular volume.
  • The average quantity of hemoglobin inside a single red blood cell is calculated as mean corpuscular hemoglobin.
  • The average concentration of hemoglobin inside a single red blood cell is calculated as mean corpuscular hemoglobin concentration.
  • The red cell distribution width is a measurement of RBC size variation.

The reticulocyte count, which is a measurement of the absolute count or percentage of immature red blood cells in the blood, may also be included in the CBC.

Platelets, which are cell fragments that are critical for proper blood coagulation, are assessed as follows:

  • The number of platelets in a person's blood sample is known as the platelet count.

With a CBC, the mean platelet volume can be reported. It's a calculation of platelet size on average.

A CBC can also reveal the platelet distribution width. It reflects the size uniformity of platelets.

Can a blood transfusion affect my CBC results?

Yes, a recent blood transfusion will have an effect on your CBC test results.

What do my Complete Blood Count results mean?

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health.

What do my Platelet results mean?

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

NOTE: Only measurable biomarkers will be reported.


Acute Myeloid Leukemia Prognostic Panel (Normal Karyotype)

Clinical Significance

This testing, consisting of FLT3, NPM-1, and CEBPA, is recommended in the NCCN guidelines for determination of AML risk status in patients with cytogenetically normal AML. The presence of CEBPA gene mutations is associated with increased disease-free survival and overall survival. Mutations in NPM1 gene is a predictor of favorable prognosis and good response to induction chemotherapy. The presence of (FLT3) internal tandem duplication is associated with short disease-free survival.


Most commonly utilized test to monitor characteristic response to infection. Diagnostically useful for diseases such as leukemia, leukocyte disorders, as well as monitoring therapy of these diseases.

A screening test for various disease states to include leukemia and inflammatory processes.

To detect AML1-ETO t (8;21) fusion transcript that is common in acute myeloid leukemia (AML) M2 subtype. Besides initial diagnosis and prognosis evaluation, this assay is intended to monitor the clinical course and effectiveness of therapy of Minimal Residual Disease (MRD). It may be valuable to monitor the disease trend in the same patient and predict the approaching relapse

This assay is used to monitor exposure to arsenic, wellness, and therapy during treatment of chronic myelocytic leukemia.

Calcitonin concentration is increased in patients with medullary thyroid carcinoma. Calcitonin concentrations may be used to monitor disease.

This Real-Time Quantitative (Reverse Transcription Polymerase Chain Reaction) for the amplification of CBFB/MYH11 fusion transcript can be used to detect the chromosome aberration of inv (16) or t (16;16). It can be used to detect Minimal Residual Disease (MRD) and assess the risk for disease relapse in inv (16) or t (16;16) Acute Myeloid Leukemia (AML).

Description: The CH50 blood test is a screening test used to measure total complement activity in your blood’s serum.

Also Known As: CH50 Test, Total Complement Test, Complement Activity Test, Total Complement Activity Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Complement Total test ordered?

When a person exhibits inexplicable edema, inflammation, or indications of an autoimmune condition like SLE, complement testing may be mandated. It may also be requested when a medical professional wants to assess the complement system of a patient who they suspect may have an immune complex-related disease.

When the total complement activity is abnormal, individual complement components may be ordered to help identify which ones are lacking or defective.

Complement testing may be used to provide a general assessment of the severity of an acute or chronic ailment after a diagnosis, with the underlying supposition that the severity is related to the decline in complement levels. Occasionally, a doctor may also request complement testing to keep track of the progression of a problem.

What does a Complement Total blood test check for?

Over 30 blood proteins make up the intricate complement system, which functions to support inflammatory and immunological responses. Its main function is to eliminate invading infections like viruses and bacteria. The body's production of antibodies against its own tissues, which occurs in autoimmune disorders, can also cause the complement system to become active. The amount or activity of complement proteins in the blood is measured by complement assays.

A component of the body's innate immune system is the complement system. The innate immune system is non-specific and rapid to react to external molecules, in contrast to the acquired immune system, which generates antibodies that target and defend against specific threats. It does not require prior exposure to an invasive drug or bacterium and does not keep track of prior interactions.

The primary complement proteins are numbered C1 through C9. There are nine of them. Together with the remaining proteins, these elements produce complexes that react to infections, non-self tissues, dead cells, or inflammation by activating, amplifying, breaking apart, and generating complexes.

Lab tests often ordered with a Complement Total test:

  • Sed Rate
  • C-Reactive Protein
  • Rheumatoid Factor
  • ANA Screen
  • Antibody Screen

Conditions where a Complement Total test is recommended:

  • Liver Disease
  • Glomerulonephritis
  • Rheumatoid Arthritis
  • Hemolytic Anemia
  • Systemic Lupus Erythematosis
  • Bacterial Endocarditis
  • Leukemia
  • Hodgkin’s Disease
  • Sarcoma
  • Behcet’s Disease

How does my health care provider use a Complement Total test?

When a person has a disease or illness, complement tests are done to evaluate whether deficiencies or abnormalities in the complement system are the root cause or a contributing factor. In order to assess the overall integrity of the classical complement pathway, total complement activity may be ordered. To check for deficits, additional complement components are obtained if necessary.

What do my Complement Total test results mean?

It's possible for complement levels to drop as a result of greater intake or, less frequently, a congenital deficiency. A high incidence of recurrent microbial infections is typically caused by a hereditary defect in one of the complement proteins. Reduced complement levels are linked to a higher risk of autoimmune disease development.

Complement levels will typically return to normal if the underlying acute or chronic ailment can be treated if the deficiency is brought on by one of these.

During acute or chronic inflammation, complement protein levels typically rise together with those of other unrelated proteins known as acute phase reactants. When the underlying illness is treated, all of these often return to normal. Comparatively to the frequently ordered C-reactive protein (CRP), complement proteins are less frequently assessed in these circumstances; hence, the value of their testing in these circumstances is not discussed here.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Clinical Significance

FISH, B-Cell Chronic Lymphocytic Leukemia Panel - This test is performed to detect the rearrangements of 6q21(SEC63),6q23(MYB),ATM(11q22.3),centromere 12(D12Z3), 13q14.3(DLEU),13q34(LAMP1) and TP53(17p13.1) regions,by FISH (fluorescence in situ hybridization). This assay is useful for prognostic assessment for chronic lymphocytic leukemia/ small lymphocytic lymphoma(CLL/SLL).


A complete blood count used as a screening test for various disease states to include: Anemia, leukemia and inflammatory processes.

A complete blood count is used as a screening test for various disease states including anemia, leukemia and inflammatory processes.

HTLV-I/II Antibody, with Reflex to Confirmatory Assay

 

Includes

If HTLV-I/II Antibody is positive, HTLV-I/II Antibody, Confirmatory Assay will be performed at an additional charge (CPT code(s): 86689)

NOTE ADDITIONAL CHARGE WILL OCCUR IF THE CONFIRMATIONARY 

Clinical Significance

HTLV-I is associated with adult T-cell lymphoblastic leukemia and B-cell chronic lymphocytic leukemia. HTLV-II is less common and is associated with neoplasias of the CD8 T lymphocytes. Blood donor screening began in 1998.


Monoclonal increases in IgG or IgA are often associated with diseases such as multiple myeloma, lymphomas or leukemia. A monoclonal increase in IgM is commonly associated with Waldenström's macroglobulinemia.

False elevations of potassium may be due to hemolysis or rupture of platelets during coagulation process. The use of plasma potassium levels should be limited to those patients with spuriously elevated or depressed potassium levels due to blood samples left at room temperature, in patients with chronic lymphocytic leukemia with very high WBC counts (false decline), and those with thrombocytosis (increased platelets) with counts in excess of one million (false elevation).

A complete blood count used as a screening test for various disease states to include: anemia, leukemia and inflammatory processes

CD20 antigen is expressed on the surface of >90% of B-cell non-Hodgkin's Lymphomas (NHL). Binding to CD20 antigen is necessary for the antitumor effect of Rituxan®.

Includes

6-Thioguanine (6-TG), 6-Methylmercaptopurine (6-MMP)

Patient Preparation 

trough specimen is required (within 1 hour prior to the next dose)

Reference Range(s)

 

6-TG 235-400 pmol/8x10(8) RBC
6-MMP <5700 pmol/8x10(8) RBC

 

Clinical Significance

6-Mercaptopurine (Purinethol) and its imidazolyl derivative, Azathioprine (Imuran), are immunosuppressive drugs. 6-Mercaptopurine (6-MP) is indicated for remission induction and maintenance therapy of acute lymphoblastic leukemia (ALL). Azathioprine is indicated as an adjunct for the prevention of rejection in renal allograft (kidney transplant) patients, for the management of rheumatoid arthritis, and for the management of inflammatory bowel disease.
Azathioprine is cleaved to 6-MP. 6-MP is metabolized via a series of enzymatic steps to 6-thioguanine nucleotides (6-TGNs), to 6-methyl-mercaptopurine (6-MMPNs) by the enzyme thiopurine methyltransferase (TPMT), and to 6-thiouric acid by the enzyme xanthine oxidase (XO). TPMT enzyme activity has large inter-individual variations which affect the efficacy, toxicity and variability of the treatment. Therapeutic drug monitoring of 6-MP metabolites (6-TGNs and 6-MMPNs) in erythrocytes is recommended to assist therapy, particularly in combination with TPMT enzyme activity or mutation analysis.


Clinical Significance

Tryptase concentrations are increased with immediate hypersensitivity (anaphylaxis), acute allergen challenge, and mastocytosis.


Most Popular

Description: A Uric Acid test is a blood test that measures Uric Acid levels in your blood’s serum to screen for goat and monitor those undergoing chemotherapy or the development of kidney stones.

Also Known As: Serum Urate Test, UA Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Uric Acid test ordered?

When a healthcare provider suspects a patient has a high uric acid level, a uric acid blood test is ordered. Gout is a prevalent form of arthritis that affects some people who have excessive uric acid levels. Gout causes discomfort in the joints, most commonly in the toes but also in other joints. When cancer patients are undergoing chemotherapy or radiation therapy, the test is also ordered to verify that their uric acid levels do not rise dangerously high.

When a person has recurring kidney stones or gout and has to be monitored for the production of these stones, a urine uric acid test may be ordered.

What does a Uric Acid blood test check for?

Purines are broken down to form uric acid. Purines are nitrogen-containing molecules that can be found in all of the body's cells, including DNA. This test determines how much uric acid is present in the blood or urine.

Cells break down as they age and die, releasing purines into the bloodstream. Purines can also be obtained through the digestion of specific foods, such as liver, anchovies, mackerel, dried beans and peas, and alcoholic beverages, particularly beer. The kidneys remove the majority of uric acid from the body, which is then excreted in the urine, with the remaining excreted in the stool.

When too much uric acid is created or not enough is eliminated from the body, it can build up in the body, causing blood levels to rise. Excess uric acid can induce gout, which is characterized by joint inflammation caused by the production of uric acid crystals in the joint fluid. Excess uric acid can also build up in tissues like the kidney, resulting in kidney stones or failure.

Too much uric acid in the body can occur as a result of creating too much, not removing enough, or a combination of both. Uric acid levels can rise as a result of an increase in cell death, as seen with some cancer treatments, or as a result of a rare hereditary tendency to make too much uric acid. Reduced uric acid removal is frequently caused by reduced renal function as a result of kidney disease.

Lab tests often ordered with a Uric Acid test:

  • Complete Blood Count
  • Iron Total and Total Iron binding capacity
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Urinalysis Complete

Conditions where a Uric Acid test is recommended:

  • Arthritis
  • Gout
  • Kidney Disease

How does my health care provider use a Uric Acid test?

The uric acid blood test is used to diagnose gout by detecting elevated levels of this molecule in the blood. The test is also used to monitor uric acid levels in persons who are receiving cancer treatment such as chemotherapy or radiation. Rapid cell turnover can lead to a rise in uric acid levels as a result of such treatment.

The uric acid urine test is used to detect the source of recurring kidney stones and to monitor the production of stones in persons with gout.

What does my Uric Acid result mean?

Hyperuricemia is defined as blood uric acid levels that are higher than usual. It can be caused by the body creating too much uric acid or the kidneys failing to eliminate enough uric acid from the body. To determine the reason of uric acid overproduction or reduced elimination, more research is needed.

Purine break-down is affected by a number of genetic inborn defects. Increased uric acid production can be caused by cancer that has spread from its original place, leukemias, multiple myeloma, and cancer chemotherapy. Reduced uric acid elimination can be caused by chronic renal illness, acidosis, pregnancy toxemia, and alcoholism.

Increased uric acid levels can cause crystals to develop in the joints, resulting in the joint inflammation and pain associated with gout. Uric acid can form crystals or kidney stones, which can cause kidney injury.

Low uric acid levels in the blood are significantly less common than high ones, and they are rarely a cause for concern. Although low uric acid levels have been linked to liver and renal disease, Fanconi syndrome, toxic exposure, and in rare cases, a hereditary metabolic deficiency, these problems are usually detected by other tests and symptoms rather than a single low uric acid result.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.



Leukemia is a form of cancer that affects the blood or blood making tissues. Bone marrow is found in the spongy regions of the bones, usually pelvis bones, sternum, vertebrae, and ribs. It is tasked with making early blood-forming cells, white blood cells, platelets, and the precursors of red blood cells. These precursors grow until they mature in the bone marrow and then released into the bloodstream. 

Well, blood cancer develops when the bone marrow forms unusual blood cells, which start to divide out of control. More often than not, this form of cancer affects the white blood cells, but it can affect other types of blood cells too. White blood cells play a significant role in fighting infections in the body, but when leukemia affects them, they become leukemia cells, and they fail to die like normal cells. Instead, they garner and crowd out the normal cells. This includes normal white blood cells, platelets, and red blood cells, as well as their precursors found in the bone marrow. This, as you can expect, leads to an array of problems, including easy bruising and bleeding, failure to get adequate oxygen to body tissues, and an increased risk of infections. 

Leukemia cells, over time, can spread through the bloodstream and blood, sometimes referred to as a liquid tumor. This is where they divide, occasionally forming solid tumors and also doing damage to body organs. Which organs sustain damage depends on the type of blood cancer. For instance, the liver, lymph nodes, and spleen may become swollen and enlarged as a result of the accumulation of the abnormal cells. In other cases, leukemia cells reach the CNS (or central nervous system) and garner in the cerebrospinal fluid. 

In the U.S alone, almost 50,000 people are diagnosed with leukemia each year, and over 23,000 die of the condition. This type of cancer usually affects adults older than 55 years, but it is also the most common form of cancer in teens and children younger than 15. The cause of this condition is not well known, but exposure to cancer-causing chemicals, radiation, and anticancer drugs have been seen to increase the risk of developing it. Some cases are due to rare viral infections and genetic disorders in others. 

Types of Leukemia 

There are several types of blood cancer. Each type is classified based on if it grows rapidly and becomes lethal fast if not treated (this is also referred to as acute blood cancer), or grows gradually (or chronic blood cancer) and also the type of white blood cell that cancer started. 

There are two categories of early blood-forming cells that produce white blood cells (or immature precursors): 

  • Myeloid Precursor Cells: These produce red blood cells and a number of white blood cells called granulocytes. The latter move in the bloodstream fighting infections through killing and digesting the harmful bacteria. 
  • Lymphoid Precursor Cells: These grow and mature into lymphocytes, a kind of white blood cell that can be found in both the lymphatic and blood circulatory system. Their role is to coordinate your body’s immune response, and a huge number of them produce antibodies. 

As such, blood cancer can be classified as Lymphoid or Myeloid. There is another type of cancer that affects the lymphocytes, but it does not occur in the bone marrow, but the lymphatic system instead. It is referred to as lymphoma, and it is diagnosed and treated rather differently. 

The Four Primary Leukemia Categories Are: 

  • ALL (or Acute Lymphocytic Leukemia) – This type of cancer tends to develop from lymphocytes yet to mature. Lymphoid leukemia cells found in acute lymphocytic leukemia are known as leukemic lymphoblasts. This form of cancer can develop quickly, and when not attended to, it can be lethal in just a few months. The cancer cells build up in the blood and bone marrow. Cancer can ideally spread to the lymph nodes and, ultimately, CNS. 

One form of acute lymphocytic leukemia is caused by two chromosome pieces breaking and switching places, referred to as translocation. This leads to an altered, fused gene on chromosome 22, referred to as the Philadelphia chromosome. This gene makes a protein that functions abnormally, leading to the overproduction of immature lymphoid cells. This form of cancer is referred to as Philadelphia chromosome-positive acute lymphocytic leukemia. 

Untreated acute lymphocytic leukemia can result in poor immunity, easy bleeding and bruising as well as anemia. The condition is common in children compared to adults. 

  • CLL (or Chronic Lymphocytic Leukemia) – This form of cancer starts in immature lymphocytes, but the leukemic cells occur in mature lymphocytes. Compared to other forms of leukemia, it grows gradually and doesn’t call for frequent treatment. It can remain stable for years, but there’s a faster-developing form of chronic lymphocytic leukemia that tend s to block normal cell production and calls for treatment. Individuals with this form of cancer have enlarged lymph nodes, known as lymphadenopathy, autoimmunity like autoimmune hemolysis, immunoglobulin deficiencies that result in poor immunity as well as an enlarged spleen. This condition primarily affects older adults. 
  • AML (or Acute Myeloid Leukemia) – This is a rapidly growing form of cancer whereby the immature myeloid cells divide continually in the bone marrow and can replace it with immature and abnormal white blood cells. When this form of cancer is untreated, it can result in poor immunity, infections, anemia, as well as easy bruising and bleeding. AML is usually common in older adults, but it can ideally occur in young adults and kids. Acute promyelocytic leukemia is a subtype example of AML that’s treated differently from other AML forms and usually has better results. 
  • CML (or Chronic Myeloid Leukemia) – This is another slowly-developing form of blood cancer. Individuals with CML usually have no symptoms initially but are usually diagnosed during a routine physical or blood test. When symptoms occur, they tend to be similar to common, less serious conditions and include stomach discomfort due to an enlarged spleen, less energy, pale skin and weight loss that’s unaccounted for. Similar to Philadelphia chromosome-positive acute lymphocytic leukemia, CML is caused by an abnormal gene (BCR/ABL) on chromosome 22. If left unattended, CML can result in poor immunity, anemia, overly enlarged spleen, and excessive bruising and bleeding. The condition is prevalent in adults, with seniors over 65 experiencing a higher risk. CML rarely affects younger adults and children, and it can be treated with drugs known as tyrosine kinase inhibitors. 

The Signs and Symptoms of Leukemia 

Blood cancer signs and symptoms tend to vary depending on the type. The acute type may cause signs and symptoms related to not having adequate normal blood cells.

The signs and symptoms include: 

  • Shortness of breath, pale skin, and weakness due to anemia (a lack of red blood cells). 
  • Fever & infections as a result of inadequate infection-fighting white blood cells. 
  • Bruising and bleeding as a result of a lack of platelets. 

Other signs & symptoms may include headaches, vomiting, seizure and confusion, joint and bone pain, night sweats, unexplained weight loss, and enlarged spleen, kidneys, lymph nodes, and/or testicles. 

Chronic leukemia, as mentioned earlier, grows gradually, and so, it may not have early signs and symptoms. It may, however, cause milder forms of the symptoms prevalent in acute blood cancer. Chronic leukemia can be found by chance during routine checkups before even any symptoms are visible. Some cases may need to be monitored for several years before treatment is needed, while others can be more aggressive. If the cancer cells start to divide more rapidly, they can lead to a blast crisis or progression to acute leukemia. This results in the production of just immature cells and worsening the condition.

Symptoms of chronic leukemia include: 

  • Feeling rundown or tired 
  • Loss of appetite and unexplained weight loss 
  • Breath shortness during normal activity 
  • Discomfort or pain in the upper left side of the stomach. Usually caused by an enlarged spleen. 
  • Pale skin 
  • Fever 
  • Bruising and bleeding easily 
  • Night sweats 

Leukemia Lab Tests 

There are several lab tests that can be used to diagnose blood cancer, determine the type as well as monitor the treatment’s effectiveness. After an effective treatment or remission, testing can also be done to check whether cancer has returned. 

The General Blood Tests Include: 

CBC (or Complete Blood Count) & WBC Differential 

These are routine tests that assess the cells circulating in the bloodstream. They count the number of cells and check the maturity as well as the proportion of the varying cells. These blood tests can give the initial indication of blood cancer. Abnormal results, like a reduced number of red blood cells and increased white blood cell count, can be as a result of leukemia but an array of chronic or temporary conditions. However, immature blood cell precursors or blasts are usually not seen in blood, and so, if present, leukemia is most likely present, and a follow-up test will be ordered. The CBC and WBC differential tests are ideally essential in monitoring the effectiveness of treatment and also the detection of recurrence. 

Blood Smear 

This is a test that is usually used to follow up the above tests with abnormal red blood cells, white blood cells, or platelets. It can also be ordered when the CBC results are unclear. In this test, a blood drop is smeared on a microscope slide and assessed for immature cells or cells with abnormal shapes, appearance, or size compared to normal ones. 

Bone Marrow Aspiration or Biopsy 

If leukemia is suspected, a bone marrow aspiration, biopsy, or both can be conducted in order to take a closer look at the marrow tissues. A specialist (pathologist) examines the sample using a microscope and evaluates the size, appearance, shape, and number of each cell type and also the proportion of mature and immature blood cells. If blood cancer is present, the next step is to determine the type and severity of the condition. This test ideally helps set a baseline for the bone marrow cells, with an attempt to see how well they respond to treatments. 

Some select tests usually include: 

  • Lumbar Puncture (or Spinal Tap) & Cerebrospinal Fluid Analysis – If blood cancer is detected in the bone marrow, a spinal tap can be done in order to help determine if cancer has spread to the cerebrospinal fluid and CNS. If cancer cells are found in the cerebrospinal fluid, additional treatment such as direct injection of a drug into the CSF may be needed. 
  • Phenotyping or Immunophenotyping by Cytometry Flow – This is a test that can help detect leukemia and also the type. 
  • Chromosome Analysis or Karyotyping – This is a cytogenetic test used to map the 46 chromosomes in cells, with the aim of detecting changes in size, number, or arrangements associated with leukemia. 
  • Molecular Testing – The malfunction of cells that control cell growth and development is one of the factors that lead to uncontrolled cancer cell growth. The malfunctions can stem from DNA abnormalities, like mutations. Laboratory tests detect the abnormalities related to some types of blood cancer. These can help guide treatment and determine the cause of the condition and even assess the effectiveness of the treatment. 

Fluorescent In Situ Hybridization 

This is another cytogenetic test that looks for alterations in chromosomes resulting from genetic variations. This test is more sensitive than chromosome analysis. An abnormal gene segment in this test is made to fluoresce or light up when bound by a particular probe. The test helps diagnose varying types of blood cancer that look similar but have