Health Guide

White blood cell cytochemistry

What is this test?

This test identifies different cell markers (chemical components) in white blood cells. It is used to help diagnose and classify blood-related cancers[1].

What are other names for this test?

  • Leukocyte cytochemistry

What are related tests?

  • Bone marrow examination
  • Flow cytometry, cell marker analysis

Why do I need this test?

Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. You may need this test if you have:

  • Acute leukemia
  • Cancer of blood and lymph system
  • CML - Chronic myeloid leukemia

When and how often should I have this test?

When and how often laboratory tests are done may depend on many factors. The timing of laboratory tests may rely on the results or completion of other tests, procedures, or treatments. Lab tests may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms appear.

Due to changes in the way your body naturally functions through the course of a day, lab tests may need to be performed at a certain time of day. If you have prepared for a test by changing your food or fluid intake, lab tests may be timed in accordance with those changes. Timing of tests may be based on increased and decreased levels of medications, drugs or other substances in the body.

The age or gender of the person being tested may affect when and how often a lab test is required. Chronic or progressive conditions may need ongoing monitoring through the use of lab tests. Conditions that worsen and improve may also need frequent monitoring. Certain tests may be repeated to obtain a series of results, or tests may need to be repeated to confirm or disprove results. Timing and frequency of lab tests may vary if they are performed for professional or legal reasons.

How should I get ready for the test?

Bone marrow:

A bone marrow biopsy is a procedure that requires written consent. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form.

Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. You should also report if you have a history of allergic or other reactions to local anesthetics. Inform the healthcare worker of any past or present bone diseases. You may need to have other tests done before a bone marrow biopsy.

To prepare for a bone marrow biopsy, you may be offered a mild sedative prior to the procedure to help you relax. To decrease pain, you will also receive a topical or local anesthetic injection at the biopsy site.

Venous blood:

Before having blood collected, tell the person drawing your blood if you are allergic to latex. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. Also tell the healthcare worker if you have felt nauseated, lightheaded, or have fainted while having blood drawn in the past.

How is the test done?

A sample of bone marrow or venous blood may be collected for this test.

Bone marrow:

Bone marrow is the tissue inside certain bones where new blood cells are made. A bone marrow sample is collected by biopsy. Local anesthesia may be used for a bone marrow biopsy. Your skin will be shaved and cleaned, and a sterile area will be prepared for the procedure. A needle will be inserted through the skin and into the bone using a twisting motion. A sample of marrow will be removed with a syringe, and another needle will be used to remove a piece of tissue. When the samples are collected, the needle will be removed.

Venous blood:

When a blood sample from a vein is needed, a vein in your arm is usually selected. A tourniquet (large rubber strap) may be secured above the vein. The skin over the vein will be cleaned, and a needle will be inserted. You will be asked to hold very still while your blood is collected. Blood will be collected into one or more tubes, and the tourniquet will be removed. When enough blood has been collected, the healthcare worker will take the needle out.

How will the test feel?

The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the procedure. Inform the person doing the procedure if you feel that you cannot continue with the procedure.

Bone marrow:

Before a bone marrow biopsy, you may receive medication to help you relax. When the numbing medicine is injected, you may feel mild discomfort or stinging. The local anesthetic is used to minimize pain, but as the procedure needle is inserted, you may feel some pressure and discomfort. You may feel brief pain as the bone marrow is removed. You may feel discomfort at the procedure site for several days.

Venous blood:

During a blood draw, you may feel mild discomfort at the location where the blood sample is being collected.

What should I do after the test?

Bone marrow:

After the sample of bone marrow is collected, pressure may be applied and a bandage will be placed over the biopsy site. You will be given instructions for when to remove the bandage, and the signs and symptoms of infection to watch for. Contact your healthcare worker if you experience a fever or increased pain, and if you see increasing redness, swelling, or pus at the procedure site.

Venous blood:

After a blood sample is collected from your vein, a bandage, cotton ball, or gauze may be placed on the area where the needle was inserted. You may be asked to apply pressure to the area. Avoid strenuous exercise immediately after your blood draw. Contact your healthcare worker if you feel pain or see redness, swelling, or discharge from the puncture site.

What are the risks?

Bone marrow: Bone marrow is collected by a procedure called aspiration and biopsy. The sample may be taken from multiple sites, but the most common site for biopsy is the pelvis. Risks of a bone marrow biopsy vary depending on the biopsy method used and the site selected for the biopsy. General risks of this procedure are infection and bleeding from the biopsy site. If you have a medical condition, or are using a medication or supplement that causes excessive bleeding, you are at a higher risk of bleeding from the procedure site.

Bone marrow biopsies performed on the sternum (breastbone) have the most risk. This area is only tested on adults, and only certain types of biopsies are done on the sternum. Due to the location and thickness of the sternum, it is rare but possible to damage the heart, major blood vessels, and the mediastinum (space of the chest that holds essential organs). A puncture to these areas could lead to severe bleeding, infection, or trapped air in the chest cavity. The person doing this procedure may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of having a bone marrow aspiration and biopsy.

Blood: During a blood draw, a hematoma (blood-filled bump under the skin) or slight bleeding from the puncture site may occur. After a blood draw, a bruise or infection may occur at the puncture site. The person doing this test may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of this test.

What are normal results for this test?

Ask your healthcare worker for the normal results of this test.

Since the test(s) are used to identify cell markers rather than measure quantities, normal ranges do not exist.

What follow up should I do after this test?

Ask your healthcare worker how you will be informed of the test results. You may be asked to call for results, schedule an appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors related to your test. Sometimes there is no follow up after you have been notified of test results. At other times follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to a specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.

Where can I get more information?

Related Companies

  • American Cancer Society -
  • National Cancer Institute -
  • The Leukemia & Lymphoma Society Inc. -


[1] Henry JB: Clinical Diagnosis and Management by Laboratory Methods, 20th ed. Saunders, 2001.

Last Updated: 7/4/2018
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