Diagnosis

Tests and procedures used to diagnose chronic myelogenous leukemia include:

• Physical exam. Your doctor will examine you and check such vital signs as pulse and blood pressure. He or she will also feel your lymph nodes, spleen and abdomen to determine whether they are enlarged.
• Blood tests. A complete blood count may reveal abnormalities in your blood cells, such as a very high number of white blood cells. Blood chemistry tests to measure organ function may also reveal abnormalities that can help your doctor make a diagnosis.
• Bone marrow tests. Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for laboratory testing. These tests involve collecting bone marrow from your hipbone.
• Tests to look for the Philadelphia chromosome. Specialized tests, such as fluorescence in situ hybridization (FISH) analysis and the polymerase chain reaction (PCR) test, analyze blood or bone marrow samples for the presence of the Philadelphia chromosome or the BCR-ABL gene.

Phases of chronic myelogenous leukemia

The phase of chronic myelogenous leukemia refers to the aggressiveness of the disease. Your doctor determines the phase by measuring the proportion of diseased cells to healthy cells in your blood or bone marrow. A higher proportion of diseased cells means chronic myelogenous leukemia is at a more advanced stage.

Phases of chronic myelogenous leukemia include:

• Chronic. The chronic phase is the earliest phase and generally has the best response to treatment.
• Accelerated. The accelerated phase is a transitional phase when the disease becomes more aggressive.
• Blast. Blast phase is a severe, aggressive phase that becomes life-threatening.