Myelogram with acute leukemia.
Trepanobiopsy is not a mandatory study for acute leukemia, but it is necessary to conduct it at low cellularity of the bone marrow or “dry” punctate to exclude aplastic anemia and subleukemic myelosis.
Cytological examination of the cerebrospinal fluid in acute leukemia is performed in all patients with acute leukemia before treatment. In the absence of pathology in acute lymphoblastic leukemia, myelomonoblastic and monoblastic acute leukemia, further prevention of neuroleukemia is carried out. With the development of neuroleukemia, it is treated, the results of which are evaluated on the basis of an analysis of the cellular composition of the cerebrospinal fluid.
Biochemical studies in acute leukemia. In most cases, biochemical parameters are within normal values, however, in certain cases of acute leukemia (ALL, monoblastic leukemia), impaired renal function (increased creatinine level) may be observed due to their infiltration with tumor cells. Specific renal infiltration and / or their increase can be documented using ultrasound or computed tomography. In some cases (with acute leukemia with hyperleukocytosis, acute lymphoblastic leukemia with organomegaly), tumor lysis syndrome is detected already in the debut of the disease.
More often, however, this syndrome occurs with the rapid lysis of cells during chemotherapy and is characterized by hypocalcemia, hyperkalemia, increased LDH levels, and hyperuricemia with the development of renal failure.
Instrumental studies for acute leukemia are not critical for acute leukemia, but their results can influence the nature of the treatment and the prognosis of the disease. Thus, radiography of the chest organs reveals an increase in mediastinal lymph nodes, pneumonia; electrocardiography – rhythm and / or conduction disturbances due to specific myocardial infiltration, anthracycline cardiomyopathy, etc.