Diagnosis

If you have signs or symptoms of acute myelogenous leukemia, your doctor may recommend that you undergo diagnostic tests, including:

• Blood tests. Most people with acute myelogenous leukemia have too many white blood cells, not enough red blood cells and not enough platelets. But sometimes the level of white blood cells can be too low. The presence of blast cells — immature cells normally found in bone marrow but not circulating in the blood — is another indicator of acute myelogenous leukemia.

• Bone marrow test. A blood test can suggest leukemia, but it usually takes a bone marrow test to confirm the diagnosis.

  During a bone marrow biopsy, a needle is used to remove a sample of your bone marrow. Usually, the sample is taken from your hipbone. The sample is sent to a laboratory for testing.

• Lumbar puncture (spinal tap). In certain situations, it may be necessary to remove some of the fluid around your spinal cord to check for leukemia cells. Your doctor can collect this fluid by inserting a small needle into the spinal canal in your lower back.
• Testing your cancer cells in the laboratory. In a laboratory, doctors test your leukemia cells to better understand which gene mutations are present. This can help determine your prognosis and guide your treatment.

If your doctor suspects leukemia, you may be referred to a doctor who specializes in blood cancer (hematologist or medical oncologist).

Determining your AML subtype

If your doctor determines that you have AML, you may need further tests to determine the extent of the cancer and classify it into a more specific AML subtype.

Your AML subtype is based on how your cells appear when examined under a microscope. Special laboratory testing also may be used to identify the specific characteristics of your cells.

Your AML subtype helps determine which treatments may be best for you. Doctors are studying how different types of cancer treatment affect people with different AML subtypes.

Determining your prognosis

Your doctor uses your AML subtype and other information to determine your prognosis and decide on your treatment options. Other types of cancer use numerical stages to indicate your prognosis and whether your cancer has spread, but there are no stages of acute myelogenous leukemia.

Instead, the seriousness of your condition is determined by:

• AML subtype
• Your age
• Your overall health
• Results from other tests and procedures, such as the number of white blood cells found in a blood sample