NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia

11 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2018 1 Chronic lymphocytic leukemia First tests for CLL Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved. First tests for CLL Your blood needs to be tested to confirm (diagnose) CLL. Often, CLL is suspected after a routine blood test that is part of your normal health care when it shows a high white blood cell or lymphocyte count. For a blood test, your doctor will insert a needle into your vein to remove a sample of blood. The needle may bruise your skin and you may feel dizzy from the blood draw. Your blood sample will then be sent to a lab where a pathologist will test it. A pathologist is a doctor who’s an expert in testing cells to find disease. The number of abnormal B-cells in your blood must be known for diagnosis. CLL requires the presence of at least 5,000 abnormal B-cells per microliter of blood (5 x 10 9 /L). The B-cells have to be copies of the same “parent” cell. This is called monoclonality. See page 8 for more information on B-cells. Figure 4 Normal cell growth vs. cancer cell growth Normal cells increase in number when they are needed and die when old or damaged. In contrast, cancer cells quickly make new cells and live longer because of abnormal changes in genes.