The process a healthcare provider uses to diagnose AML involves a physical exam, collecting the patient's personal and family medical history, and blood tests. Tests and procedures that may be used to make the diagnosis include complete blood count, blood chemistry studies, peripheral blood smear, and a biopsy. Once the diagnosis is confirmed, additional tests determine if and where the cancer has spread.
If a person has possible symptoms of AML, the doctor may perform a physical exam, ask about the patient's personal and family medical history, and order laboratory tests, especially blood tests.
Tests and procedures that may be used to help make an AML diagnosis include:
- 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): This is a procedure in which a sample of blood is drawn and checked for 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 and the portion of the sample made up of red blood cells.
- Blood chemistry studies: This is 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 produces it.
- Peripheral blood smear: A procedure in which a sample of blood is checked for blast cells, number and kinds of white blood cells, number of platelets, and changes in the shape of the blood cells.
- Biopsy: The removal of cells or tissues so that they can be viewed under a microscope to check for signs of cancer.
- Bone marrow aspiration and biopsy: The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist will then view both the bone marrow biopsy and the bone marrow aspiration samples under a microscope to look for abnormal cells.
- Tumor biopsy: A biopsy of a chloroma may be done. A chloroma is a solid tumor composed of immature malignant (cancerous) white blood cells called myeloblasts.
- Lymph node biopsy: The removal of all or part of a lymph node. A pathologist will then view the tissue under a microscope to look for cancer cells.
- Cytogenetic analysis: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if there are changes in the structure or number of chromosomes in the cells.
- Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell, that may include special staining of the blood and bone marrow cells. This process is used to diagnose the subtype of AML by comparing the cancer cells to normal cells of the immune system.
- Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column by placing a needle into it. This procedure is also called an LP or spinal tap.