lumbar puncture and cerebrospinal fluid (CSF) fluid for cytology
bone marrow aspirate and biopsy
CT scan abdomen
In acute lymphoblastic leukemia (ALL), a bone marrow analysis is the most important test in confirming the diagnosis. Once the diagnosis of ALL is established, CSF fluid (leukemic cells in the CSF can be identified in up to a third of all patients at diagnosis) and CXR are important tests in the workup of the patient. It is the most common malignancy in children under age 15 in the United States, accounting for 25% of all cancers in White children. It is less common in Black children.