Diagnosis of Adult Acute Myeloid Leukemia

Tests that examine the blood and bone marrow are used to detect (find) and diagnose Adult Acute Myeloid Leukemia. The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells, white blood cells, and platelets.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the sample made up of red blood cells.
  • Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
  • Peripheral blood smear: A procedure in which a sample of blood is checked for the presence of blast cells, number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
  • Cytogenetic analysis: A laboratory test in which the cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes.
  • Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell. This process is used to diagnose the subtype of AML by comparing the cancer cells to normal cells of the immune system.
  • Reverse transcription – polymerase chain reaction test (RT–PCR): A laboratory test in which cells in a sample of tissue are studied using chemicals to look for certain changes in the structure or function of genes. This test is used to diagnose acute promyelocytic leukemia (APL).

Prognosis

The prognosis (chance of recovery) and treatment options depend on:
  • The age of the patient.
  • The subtype of Adult Acute Myeloid Leukemia.
  • Whether the patient received chemotherapy in the past to treat a different cancer.
  • Whether there is a history of a blood disorder such as myelodysplastic syndrome.
  • Whether the cancer has spread to the central nervous system.
  • Whether the cancer has been treated before or recurred (come back).

Stages of Adult Acute Myeloid Leukemia

Once adult acute myeloid leukemia (AML) has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body. The following tests and procedures may be used to determine if the leukemia has spread:
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs in the abdomen and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
When cancer cells spread outside the blood, a solid tumor may form. This process is called metastasis. The three ways that cancer cells spread in the body are:
  • Through the blood— Cancer cells travel through the blood, invades solid tissues in the body, such as the brain or heart, and form a solid tumor.
  • Through the lymph system— Cancer cells invade the lymph system, travel through the lymph vessels, and form a solid tumor in other parts of the body.
  • Through solid tissue— Cancer cells that have formed a solid tumor spread to tissues in the surrounding area.
There is no standard staging system for adult AML. The disease is described as
  • Untreated
  • In remission
  • Recurrent

Untreated Adult AML

In untreated adult AML, the disease is newly diagnosed. It has not been treated except to relieve symptoms such as fever, bleeding, or pain, and the following are true:
  • The complete blood count is abnormal.
  • At least 20 percent of the cells in the bone marrow are blasts (leukemia cells).
  • There are signs or symptoms of leukemia.

Adult AML in Remission

In adult AML in remission, the disease has been treated and the following are true:
  • The complete blood count is normal.
  • Less than 5% of the cells in the bone marrow are blasts (leukemia cells).
  • There are no signs or symptoms of leukemia in the brain and spinal cord or elsewhere in the body.

Recurrent Adult AML

Recurrent AML is cancer that has recurred (come back) after it has been treated. The AML may come back in the blood or bone marrow. If you are experiencing the signs or symptoms of AML, contact us to request an appointment with our cancer doctors to begin diagnostic testing.