From the Guidelines
A Complete Blood Count (CBC) can help detect signs of blood cancers, such as leukemia, lymphoma, or multiple myeloma, but cannot definitively diagnose them on its own. The CBC measures various components of blood including red blood cells, white blood cells, platelets, and hemoglobin levels [ 1 ]. Abnormalities such as unusually high or low white blood cell counts, anemia, or low platelet counts may suggest the possibility of blood cancers. However, these abnormalities can also be caused by many other conditions including infections, vitamin deficiencies, or medication side effects [ 1 ].
Key Points to Consider
- A CBC with manual differential should be performed at the initial visit to establish a baseline for future comparison [ 1 ].
- The CBC should be examined for leukemic blasts or dysplastic changes, enumeration of the platelet count, and examination of the MCV [ 1 ].
- If a CBC shows concerning results, additional testing is typically required for a definitive diagnosis of blood cancer, such as blood smears, bone marrow biopsies, flow cytometry, genetic testing, or imaging studies [ 1 ].
- The frequency of CBC testing may vary depending on the leukemia-predisposing condition, patient and family preferences, and availability of insurance or other financial resources [ 1 ].
Surveillance and Follow-up
For children at high risk for MDS/AML, routine follow-up CBCs should be used to monitor for disease progression [ 1 ]. The frequency of CBC testing should be individualized based on the underlying genetic condition and the patient's risk factors. Annual follow-up bone marrow evaluation with cytogenetic analysis should be offered for children at greatest risk for BMF and/or MDS/AML [ 1 ].
From the Research
Blood Cancers and CBC
- A Complete Blood Count (CBC) is a blood test that measures various components of the blood, including red and white blood cells, platelets, and hemoglobin [@\4@].
- While a CBC can indicate abnormalities in the blood that may suggest the presence of blood cancers, such as leukemia, it is not a definitive diagnostic tool [@\4@].
- Blood cancers, including leukemia, can be detected through a range of diagnostic techniques, including bone marrow biopsy and aspiration, peripheral blood smear, and cellular immunophenotyping [@\3@, @\4@].
Diagnostic Techniques for Blood Cancers
- Bone marrow biopsy is a diagnostic technique that involves examining a sample of bone marrow tissue to detect abnormalities, including cancer cells [@\1@, @\2@, @\3@, @\5@].
- Bone marrow biopsy can provide important information for diagnostic and prognostic purposes, including the detection of chronic lymphocytic leukemia (CLL) [@\1@, @\2@, @\3@, @\5@].
- Peripheral blood smear and cellular immunophenotyping are also useful diagnostic techniques for detecting blood cancers, including CLL [@\3@].
Limitations of CBC in Diagnosing Blood Cancers
- A CBC may not always detect blood cancers, especially in the early stages of the disease [@\4@].
- Further examination of the bone marrow or peripheral blood is often necessary to confirm a diagnosis of blood cancer [@\4@].