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15

NCCN Guidelines for Patients

®

:

Acute Lymphoblastic Leukemia, Version 1.2017

2

Testing for ALL

Physical exam

Guide 2. Initial tests for diagnosis

Tests of blood or bone marrow needed for all patients

• Cell assessment (morphologic assessment)

• Cytogenetic testing

• Flow cytometry

• FISH (

f

luorescence

i

n

s

itu

h

ybridization)

• PCR (

p

olymerase

c

hain

r

eaction)

Guide 3. Tests for treatment planning

Tests needed for all patients Tests that may be needed in some cases

• Medical history, physical exam, and check for

infections

• HLA (

h

uman

l

eukocyte

a

ntigen) typing

• Pregnancy testing, fertility counseling and

preservation

• MRI (

m

agnetic

r

esonance

i

maging) or CT (

c

omputed

t

omography) of the head, if symptoms

• CBC (

c

omplete

b

lood

c

ount) with differential

• If concern for cancer in lymph nodes:

• CT of neck/chest/abdomen/pelvis and PET/

CT (

p

ositron

e

mission

t

omography/

c

omputed

t

omography)

• Blood chemistry profile and liver function tests • Testicular exam, including ultrasound of the scrotum as

needed

• Hepatitis B/C, HIV (

h

uman

i

mmunodeficiency

v

irus), CMV (

c

yto

m

egalo

v

irus) Ab testing

• Echocardiogram or cardiac nuclear medicine scan

• Blood clotting tests

• TLS (

t

umor

l

ysis

s

yndrome) panel

• Lumbar puncture with IT (

i

ntra

t

hecal)

chemotherapy

• Urinalysis