Diagnosis
If you have any of these signs and symptoms, see your doctor as soon as possible, as this disease may progress rapidly. Your doctor will take your medical history and conduct a physical exam. If your doctor suspects AML, samples of your blood and bone marrow will be taken analyzed for signs of the disease. Your doctor may recommend any of the following procedures as part of this process:
Complete Blood Count (CBC)
A complete blood count (CBC) measures the levels of different types of cells in your blood. People with AML often have high levels of immature white blood cells (myeloblasts). These abnormal cells may crow out healthy blood cells and cause conditions like anemia, leukopenia, and thrombocytopenia.
Peripheral Blood Smear
In this test, a blood specialist will examine a sample of your blood under a microscope. Your doctor will look at the appearance and amount of the different types of cells in your blood and look for any abnormalities that may indicate AML.
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Bone Marrow Aspiration & Biopsy
Your doctor will perform this procedure to get a sample of your bone marrow for further testing. For this test, a doctor or nurse will numb the patient's hip bone and use a needle to extract some solid bone and some bone marrow. The doctor will then examine the bone marrow tissue under a microscope to see if there are any leukemia cells present. This test can be done in the hospital or doctor's office, and most patients can go home right after the test.
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Cytochemistry/Immunocytochemistry
In these tests, special stains or antibodies will be applied to a sample of your blood or bone marrow. These substances react with certain types of cells present in leukemia, and produce visible stains. There is one stain that causes black spots to appear in AML cells, allowing doctors to distinguish between AML and ALL.
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Flow Cytometry
Doctors commonly use this test to help diagnose AML. In this procedure, your doctor will expose a sample of your blood or bone marrow to special antibodies that attach themselves only to certain substances in your cancer cells. Your doctor then moves the sample through a laser beam, which causes the antibodies to light up. This test helps your doctor identify the specific types of cells in your leukemia, helping him get a better idea of the maturity and origin of the cancer cells. This test is important in tuning the diagnosis and monitoring for minimal residual disease.
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Cytogenetic Tests
Your doctor will examine your cancer cells for chromosome changes in order to determine the specific characteristics and subtype of your disease. For these tests, your doctor will grow a sample of bone marrow cells in the lab and examine the chromosomes under a microscope once the cells start dividing. Cell division is the easiest time to see the chromosomes. The finding of this test is very important in dictating the type of treatment and the outcome of the disease.
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Fluorescent in situ hybridization (FISH)
Doctors also use this test to detect changes in the chromosomes and DNA of your blood or bone marrow samples. Your doctor will expose the sample to special dyes that will bind to specific parts of certain chromosomes. These dyes help your doctor detect any abnormalities in the chromosomes known to play a role in AML. This test is much faster than cytogenetics tests because the cell sample doesn't have to be grown in a lab.
Polymerase Chain Reaction (PCR)
The doctor may perform this DNA test on a sample of your blood or bone marrow. Doctors use this test to detect chromosome abnormalities that cannot be seen under a microscope because they are too small. This test is very sensitive and can detect these abnormalities even if there are very few leukemia cells in the sample. This technique is used to monitor the minimal residual disease status.
DNA Sequencing
The doctor may perform an advanced test on your DNA in order to identify certain mutations. The identification of certain mutations can predict disease outcome. Also, some drugs used to treat AML specifically target certain mutations, so certain mutations may affect the treatment that your doctor recommends.
