Your doctor must complete a full physical exam and conduct blood and bone marrows tests to diagnose ALL. They’ll likely ask about bone pain, which is one of the first symptoms of ALL. Some of the possible diagnostic tests you might need include the following:

Your doctor may order a blood count. People who have ALL may have a blood count that shows low hemoglobin and a low platelet count, and their white blood cell count may or may not be increased.

A blood film may show immature cells circulating in the blood, which are normally found in bone marrow.

Bone marrow aspiration involves taking a sample of bone marrow from your pelvis or breastbone, and it provides a way to test for increased growth in marrow tissue and reduced production of red blood cells. It also allows your doctor to test for dysplasia, which is an abnormal development of immature cells, in the presence of leukocytosis, or increased white blood cells.

A chest X-ray can allow your doctor to see if the mediastinum, or the middle partition of your chest, is widened.

A CT scan helps your doctor determine whether cancer has spread to your brain, spinal cord, or other parts of your body.

A spinal tap is used to check if cancer cells have spread to your spinal fluid.

Tests on serum urea, renal, and liver biochemistry may be done.

An electrocardiogram and echocardiogram of your heart may be performed to check left ventricular function.