Last Updated on Jun 22, 2020

AML - Diagnosis

A microscopic examination of the morphology and numbers of the blood cells helps to diagnose AML. Bone marrow aspiration should reveal at least 20% blasts to confirm diagnosis of AML

If the symptoms indicate that a patient has leukemia, the doctor will need to check samples of cells from the patient's blood and bone marrow to be sure of the diagnosis.

Blood Test / Blood cell examination: When observed under the microscope, changes in the morphology and numbers of different types of blood cells help to diagnose leukemia. Blood cell analysis of most patients with AML show the following -

  • Increased numbers of white cells
  • Decreased numbers of red blood cells
  • Decreased numbers of platelets
  • Increased number of immature WBC

Bone marrow examination: A sample of bone marrow cells confirms the diagnosis. A sample is taken from the hipbone by inserting a special needle and navigating it through the bone using a twisting motion. A small amount of aspirate is collected for microscopic examination. This is followed by a bone marrow biopsy by moving the needle further into the bone and removing a portion of the core tissue to be examined microscopically.

The percentage of ‘blasts’ in the bone marrow is particularly vital. At least 20% blasts in the marrow are required for a diagnosis of AML. The bone marrow analysis helps to diagnose leukemia and also to tell if the patient is responding to treatment. In order for a patient to be considered to be in remission after treatment, the blast percentage must be no higher than 5% .

Other diagnostic studies undertaken to guide treatment are -

  • Blood chemistry tests: In patients with leukemia, these tests help to identify liver or kidney problems due to the spread of leukemic cells or due to the side effects of certain chemotherapy drugs.
  • Lumbar puncture or spinal tap: In this procedure, a small needle is used to withdraw cerebrospinal fluid (CSF) from the spinal cavity to be examined for leukemia cells. This is not routinely done for patients with AML.
  • Chromosomal aberrations: AML can also be diagnosed if the blasts have a chromosome aberration that is specific to an AML subtype. This is considered even if the percentage of blasts is less than 20%. In certain types of leukemia, exchange of DNA may take place between two chromosomes. This is called a translocation, and can be seen under a microscope. Other aberrations such as inversions, deletions, or additions, are also possible. Recognizing these changes helps to identify the type of AML and is important in determining the prognosis of the patient.
  • Cytochemistry: This study involves placing the sample on a microslide and exposing them to chemical stains. These stains react with only certain types of leukemia cells. For example, one-stain causes the granules of AML cells to appear as black spots when observed under the microscope and does not cause changes in ALL cells. These changes that can be seen only under a microscope.
  • Flow cytometry: This technique is often used to examine the cells from bone marrow and blood samples. It is very accurate in determining the exact type of leukemia. Special antibodies are created which stick to certain molecules on the leukemic cells. The cells are then passed in front of a laser beam. If the sample contains leukemic cells they emit light, which is measured and analyzed by a computer.
  • Immuno cytochemistry: As in flow cytometry, cells from the bone marrow aspiration or biopsy sample are treated with special antibodies that react only to certain molecules. But instead of a laser, the sample is treated in such a way so that certain cells types change color, which can be seen only under a microscope. It is helpful in distinguishing different types of leukemia from one another and from other diseases.
  • Molecular genetic studies: Special molecular studies, such as FISH, are also employed
  • Imaging Studies: Imaging tests are of limited value as no visible tumors are usually formed. Imaging studies such as X-ray, CT scan, MRI scan and ultrasound are usually done to look for infections or other problems cells.


PurushNaidu Friday, December 20, 2013

my friend surfing with acute myeloblastic leukemia with maturation. Now he going on chemotherapy. He is on my 2nd session[0, 1 ,2]. Still two more session as per the doctor. Also Doctor's told good progress. I want to know what type of food will add more value to get more immunity. Please give some suggestion on food from nature.

epikia Tuesday, November 27, 2012

Hi.. i am 23 years old diagnose with AML last October 2012 and currently receiving chemotherapy. i am on my 2nd session and my doctor said i will have another session this december. id like to know when they say 5 years survival does that mean i only have 5years left eventhough i take my chemotherapy?

Vikram_Muddya Thursday, November 29, 2012

No, that only means that they certify that your cancer is cured only after 5 years, till then they monitor and see that it doesn't relapse by then.

mehul23 Tuesday, June 12, 2012

78 years aged mother suffering from lukemia pls tell me about the effective medicine and tell me about the chancec or not for recovery.. and which medicine are good for the acute lukemia pls write some medicines name for the recovery for the patitent Tuesday, December 4, 2012

plz take your mother to cancer hospital.the medicine is depends up on the type of leukemia.

Ravikohli Tuesday, February 28, 2012

I have Acute Leukemia[AML] cancer to my sister. Her age is 25 years. In recent test reports Blast are about 80%. Can you please tell me how i can proceed to cure my sister.

Nimat Wednesday, February 2, 2011

Hello.i just read about AML and i am satisfied with the information providede. Though i have one small enquiry; Anthracycline has been listed as one of the drugs given during Chemotherapy that may cause AML in the future and yet it has been listed as a drug for treating AML. Doess it mean that you are at risk of contracting AML again? I will apprecite your assistance on this qustion..

simipaknikar Sunday, February 6, 2011

Anthracyclines have been found to produce AML in patients who underwent treatment for breast cancer and Hodgkin's lymphoma, especially when used with other anticancer drugs and in high doses. Currently anthracyclines are very effective in AML, and the risk of them causing AML are small, hence they are used in AML.

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