Diagnosing AML and disease progression

According to the American Cancer Society, there is a specific list of recommended screening tests for certain kinds of cancers, but as of yet, there are no special tests recommended to find acute myeloid leukemia early – instead, they recommend that the best way to receive an early diagnosis or find leukemia early is to report any possible symptoms of leukemia to your doctor right away.

Symptoms of leukemia are generally non-specific, and include the following:

• Weight loss
• Fatigue
• Fever
• Night sweats
• Loss of appetite

More information about detailed symptoms will be discussed in a future blog.

If AML is suspected, your doctor will do a series of tests after a thorough collection of your medical history and physical assessment. 

Blood samples are generally taken from a vein in the arm. Since AML is caused by problems with abnormal blood cells, your doctor will need a sample to confirm a trends in an AML diagnosis. With a blood sample, they can run a Complete Blood Count and Peripheral Blood Smear to analyze the different kinds of blood cells and the maturity of various white blood cells.

Bone marrow samples are obtained either by obtaining a bone marrow aspiration or a bone marrow biopsy. These are generally taken from from the back of the pelvic hip bone, but can be taken from other sites as well. In an aspiration, you will lie on your side or belly and receive a local anesthetic by an injection, and after you are numbed, the provider will insert a hollow needle into your bone to withdraw liquid bone marrow. A bone marrow biopsy is done after an 
aspiration, and is done with a slightly larger needle than the one used for aspiration. This removes a small piece of bone for further inspection. The bone marrow tests are used to help diagnose leukemia.


Cytogenetics look at cell's chromosomes under a microscope. Normally, human cells have 23 sets of chromosome that are all generally a certain expected shape and size. Sometimes in AML, the chromosomes of cells have changes that are identifiable under the microscope.






Cytochemistry tests stain cells with chemical dyes that specifically react to certain kinds of leukemia cells. The different colors of the stains help the provider determine what types of cancer cells may be present, for example, AML cells will present differently from ALL cells.





Imaging tests that can help diagnose AML include x-rays, Computed Tomography (CT) scans, and magnetic resonance imaging scans (MRI's). These all create pictures from inside the body. Leukemia doesn't often form tumors, so imaging tests aren't always the most helpful. But when imaging tests are done in people with AML, it is most often to identify infections or other problems from the disease, and not specifically leukemia itself.