Laboratory parameters of 1st order – obligatory laboratory tests.
- Small blood count [Caution. Leukocyte count is not very conclusive for leukemia, because acute leukemias can also be subleukemic, i.e., with normal or even slightly elevated leukocyte count].
- Differential blood count
- Coagulation parameters – Quick or PTT (partial thromboplastin time).
- Inflammatory parameters – CRP (C-reactive protein).
- Renal parameters – urea, creatinine if necessary creatinine clearance.
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) , LDH.
- Cytology with blood smear, bone marrow (cytology and histology), if necessary, CSF puncture (collection of cerebrospinal fluid by puncture of the spinal canal) for CSF diagnosis; immunophenotypic classification; lymphocyte differentiation;
- MRD testing: identification of very low levels of malignant cells (“minimal residual disease, MRD; minimal residual disease) from bone marrow [for therapy management]:
- Immunophenotyping by flow cytometry (method of laboratory medicine used to analyze cells flowing individually at high speed past an electrical voltage or light beam) – allows subclassification of ALLs, which also allows conclusions to be made about clinical therapy and prognosis of each ALL subtype
- PCR analysis
- Cytogenetic analysis and molecular genetics.
