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The diagnosis of bone marrow cancers is one of the most frequently inquired topics by patients. The answers regarding how these types of cancer are detected vary depending on the specific type of the disease:
Acute Leukemias (AML, ALL): Microscopic examination of the blood through a peripheral blood smear test is the initial step. However, to determine the subtype of acute leukemia (Acute Myeloid Leukemia - AML or Acute Lymphoblastic Leukemia - ALL), special tests such as flow cytometry are performed to identify surface markers of the cells affecting the bone marrow.
Chronic Myeloid Leukemia (CML): For diagnosis, it is essential to demonstrate the pathological BCR-ABL gene resulting from the translocation between chromosomes 9 and 22, or this chromosomal abnormality itself. While bone marrow biopsy is not mandatory for diagnosis, it may be performed to determine the patient's risk group, staging, and clinical course.
Chronic Lymphocytic Leukemia (CLL): A peripheral blood smear test raises suspicion if there is an increase in mature lymphocytes and the presence of "basket cells," which result from the crushing of lymphocytes during the smear preparation. Definitive diagnosis is made using flow cytometry, a test that identifies the surface antigens (identity markers) of these cells. In this case, bone marrow biopsy is generally not required for diagnosis.
Multiple Myeloma: Bone marrow biopsy is mandatory for the diagnosis of this disease. The presence of abnormal plasma cells in the bone marrow at a certain proportion is a diagnostic criterion. Additionally, the detection of abnormal proteins produced by abnormal plasma cells in blood and urine is of great importance for both diagnosis and monitoring the treatment response of the disease.
How is Bone Marrow Cancer Detected?
Acute Leukemias (AML, ALL): Microscopic examination of the blood through a peripheral blood smear test is the initial step. However, to determine the subtype of acute leukemia (Acute Myeloid Leukemia - AML or Acute Lymphoblastic Leukemia - ALL), special tests such as flow cytometry are performed to identify surface markers of the cells affecting the bone marrow.
Chronic Myeloid Leukemia (CML): For diagnosis, it is essential to demonstrate the pathological BCR-ABL gene resulting from the translocation between chromosomes 9 and 22, or this chromosomal abnormality itself. While bone marrow biopsy is not mandatory for diagnosis, it may be performed to determine the patient's risk group, staging, and clinical course.
Chronic Lymphocytic Leukemia (CLL): A peripheral blood smear test raises suspicion if there is an increase in mature lymphocytes and the presence of "basket cells," which result from the crushing of lymphocytes during the smear preparation. Definitive diagnosis is made using flow cytometry, a test that identifies the surface antigens (identity markers) of these cells. In this case, bone marrow biopsy is generally not required for diagnosis.
Multiple Myeloma: Bone marrow biopsy is mandatory for the diagnosis of this disease. The presence of abnormal plasma cells in the bone marrow at a certain proportion is a diagnostic criterion. Additionally, the detection of abnormal proteins produced by abnormal plasma cells in blood and urine is of great importance for both diagnosis and monitoring the treatment response of the disease.