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Diagnosis and what to expect

See how doctors diagnose leukemia.

Leukemia is a broad term for blood cancers caused by genetic changes in bone marrow cells. Different types have different signs including tiredness, weakness, shortness of breath, and infections that won’t go away.

Your diagnosis is based on a biopsy as well as imaging results, biomarker testing, and other lab tests.

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Biopsy

A leukemia biopsy usually involves surgically collecting small pieces of bone and bone marrow, then examining them in a lab. Biopsies can also be performed by removing all or part of a lymph node. Gene, chromosome, blood, and other bone marrow tests may also be used.

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Biomarker testing

Biomarkers are signals in cancer cells that can show how cancer may change, grow, or respond to treatment. Biomarker testing may be done at the same time as a biopsy.

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Have you asked about biomarker testing?

Biomarker testing can help your care team design a treatment plan tailored to you. We’ll help you build a discussion guide you can take to your next visit.

Get started

Take a deeper look at biomarkers

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Not all types of leukemia are the same.

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Leukemia types are mainly classified by whether it’s acute (fast growing) or chronic (slower growing), and whether it starts in
immature (myeloid) cells or certain white blood (lymphoid) cells. Biomarker testing may also be used to further determine
type.
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Find out more about your leukemia.

Select a type

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Did you know?

Instead of stages, active leukemia is classified based on white blood cell counts, gene changes, and how far it has progressed.

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Explore treatment types

There’s more than one way to treat leukemia.

Your leukemia treatment plan may include more than one type of treatment and will depend on a few factors:

  • The type of leukemia you have
  • The classification of your leukemia
  • Your biomarker status
  • Your overall health, including your age and any previous or current health conditions you’ve had or are managing

Knowing about different treatments helps you talk about them with your doctor and take an active role in your care.

Remember to ask about the side effects, risks, and benefits of any cancer treatment.

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Chemotherapy

Chemotherapy, or chemo, uses a combination of two or three powerful medications to attack and stop cancer cells from growing. It can also kill some healthy cells, which is why people may experience side effects, like hair loss.

Typically a fluid delivered into a vein (IV), it may also be given as an injection or pills.

Chemo is often used to treat cancers that, like leukemia, have spread throughout the body.

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Radiation therapy

Radiation therapy uses high-energy rays to destroy cancer cells. Different radiation techniques and schedules may be used depending on the type of leukemia you have.

Radiation may be used in combination with chemotherapy

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Bone marrow transplant

Bone marrow, the spongy tissue inside some bones, contains stem cells. When you have leukemia, these cells become cancerous. A bone marrow transplant replaces these stem cells with healthy ones.

Chemotherapy and radiation therapy are required before a transplant to help destroy the faulty cells first.

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Immunotherapy

A therapy that boosts your body’s own immune system to fight cancer or helps train the immune system to attack certain cancer cells. Two kinds of immunotherapy you may hear about are monoclonal antibodies and CAR T-cell therapy.

  • Monoclonal antibodies: These are man-made cancer fighting cells that target a specific part of leukemia cells. They may be used alone or with other treatments and are given as an IV or injection
  • CAR T-cell therapy (chimeric antigen receptor): A sample of your blood is taken and put through a lab process to separate out T cells. The cells are then changed in a way that allows them to attach to cancer cells before being put back into your body. The T cells then boost the immune system and help it destroy cancer cells
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Splenectomy

This surgical procedure is used in CLL to remove the spleen if it has become enlarged with cancer cells and is pressing on other organs. It does not treat CLL but may help relieve discomfort, improve blood cell counts, and lower the need for transfusions.

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Targeted therapy

Targeted therapy is designed to act on specific features of cancer cells, such as proteins or gene changes identified through biomarker testing, although it can also affect some normal cells. It’s also called personalized or individualized therapy and is used alone or with chemo.

Targeted therapy is usually given as a pill but can also be an infusion (IV) or injection.

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Clinical trials

If available treatments aren’t a fit for your particular cancer, participating in a clinical trial may be right for your situation. Clinical trials study the safety and efficacy of potential new medicines, including cancer treatments. Your doctor can tell you about the benefits and risks, and whether taking part in a clinical trial is right for you.

Explore clinical trials

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Ways to work with your care team

From questions to clarity, your doctor can help.

Diagnosis, testing, and treatment types can bring lots of questions. We can help prepare you to get the most out of your conversations.

Get ready

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Get answers about your diagnosis.

  • What type of cancer do I have?
  • Has it spread or grown?
  • What stage is my cancer?

Get more diagnosis questions

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Talk about your treatment plan.

  • What types of treatment are used for my cancer?
  • If biomarker testing was done, how do the results impact my treatment plan?
  • What are the goals of my treatment plan?

Get more treatment questions

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Ask about support and resources.

  • What support services are available?
  • Who can help me navigate care and next steps?
  • Who on my care team can I reach out to when I have questions?

Get more support questions

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We’re committed to helping you afford your Pfizer prescriptions.

From co-pay cards to help navigating insurance approvals, we’ll guide you to the right support. And if you’re eligible for our programs, we’ll help you get the Pfizer medicines you need.

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You could help advance a breakthrough.

Clinical trials study the safety and efficacy of potential new medicines, including cancer treatments.

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Explore clinical trials
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Living with cancer

Get a little inspiration.

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I don't feel I have cancer when I'm on the stage.”

Fred

Actual patient with cancer

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I find opportunities where...I can share info to hopefully make [other patients] feel more comfortable.”

Kanesha

Actual patient with cancer

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Still have questions?

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What are targeted therapies?

Targeted therapies are treatments that target the ways cancer cells grow, divide, and spread. One of the ways doctors determine if targeted therapies make sense in a treatment plan is through biomarker testing.

Find out more about biomarker testing

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What can I do if I’m having trouble affording my medicine?

Managing treatment costs and paying for your medicine can be overwhelming. We’ve got resources on how to help manage costs and information on where you may be able to find financial support for Pfizer medications.

Get help navigating costs

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Can I still go to work if I’m getting cancer treatment?

About half of people living with cancer are at an age where they’re still working. If you’re one of them, you may be wondering about how to talk to your co-workers about what you’re going through, what you need, and your ability to do your job. We’ve got you covered.

Communicating what you need at work

Getting back to work after treatment

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Are there communities and advocacy groups I can join?

There are many patient advocacy and support groups in the leukemia community. Here are a couple to get you started with connecting to other patients and caregivers, as well as resources to support you during your journey:

www.bloodcancerunited.org

www.leukemiarf.org

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How do race and ethnicity affect my outlook for leukemia?

The outlook for a leukemia diagnosis is different among some racial and ethnic groups.

  • Acute lymphoblastic leukemia has a higher incidence and worse overall survival in the Hispanic population
  • Black and Hispanic people have a higher mortality rate from acute leukemia cases than non-Hispanic White people
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What is the difference between leukemia, lymphoma, and multiple myeloma?

All 3 are blood cancers, but each starts in and affects different parts of the body. Leukemia causes bone marrow to produce large amounts of abnormal blood cells. Lymphoma starts in cells that are part of the immune system. Multiple myeloma affects cells made in the bone marrow called plasma cells.

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When should I seek a second opinion?

Getting a second opinion is a common process that can give you peace of mind. You may want or need a second opinion because:

  • You have a rare type of cancer and want to be sure of your diagnosis
  • Your doctor gives you limited treatment options, and you think other treatments might be available at a different medical center
  • Your doctor is not a specialist in your type of cancer
  • Your doctor tells you there is uncertainty about your type or stage of cancer
  • You’re having trouble understanding and communicating with your doctor, or you want your options explained by someone else
  • You feel uncomfortable with your doctor and their ability to answer your questions or give you the time you need
  • Your insurance company asks you to get another opinion before you start treatment
  • You want to feel confident in your treatment plan