At this time, there are no special tests that can find acute myeloid leukemia (AML) early. Report any possible symptoms of AML to your doctor right away.
People known to have a higher risk of AML because they have certain blood problems or syndromes or because they were treated with certain chemotherapy drugs or radiation should have careful, regular medical checkups. They do not usually get leukemia, but they and their doctors should be aware of the possible symptoms of AML.
Medical history and physical exam
Most of the symptoms seen in leukemia can also be caused by other problems like infections. If signs or symptoms suggest you might have leukemia, the doctor will want to ask you questions about your health (get a medical history), such as how long you have had symptoms and whether or not you have any risk factors.
The doctor will likely do a physical exam to look for any enlarged lymph nodes, bleeding or bruising, or signs of infection. If there seems to be a problem with blood cell counts, blood tests will be done. If the results suggest leukemia, your doctor may refer you to a cancer doctor (an oncologist) or a blood doctor (a hematologist), who may do one or more of the tests described below.
Types of samples used to test for AML
The doctor will need to check samples of cells from your blood and bone marrow confirm that you have leukemia. Other tissue and cell samples may also be taken to help guide treatment.
Blood samples to check for AML are most often taken from a vein in the arm.
Bone marrow samples
Bone marrow samples are taken through procedures called bone marrow aspiration and biopsy. These are 2 tests, but they are done together. In bone marrow aspiration, a thin needle and syringe is used to take out a small amount of liquid bone marrow. During a bone marrow biopsy, a small cylinder of bone and marrow is removed with a slightly larger needle.
Both samples are usually taken at the same time from the back of the hipbone (but sometimes other bones are used instead). The area is numbed before the samples are taken, but most people still have some brief pain during these tests.
These tests are used to tell whether leukemia is present. If you are having treatment, they can also be used to see how well treatment is working.
A test called a spinal tap (lumbar puncture) might be done to look for leukemia cells in the fluid around the brain and spinal cord (cerebrospinal fluid or CSF). The doctor first numbs a place in the lower part of the back over the spine. A small needle is placed between the bones of the spine in the lower back to draw out some of the fluid. The fluid is looked at for leukemia cells.
This test is not usually done for people with AML. It may be done if the doctor suspects that the leukemia has spread to the CSF based on certain symptoms. It can also be used to put chemo into the CSF if the leukemia has already spread there.
One or more of these lab tests may be done on the samples to tell if you have AML and to learn the exact type.
Blood cell counts and exams
Changes in the numbers of different blood cell types and how the cells look under a microscope can suggest leukemia. Most people with AML will have too many white blood cells and not enough red blood cells or platelets. Also, many of the white cells will be blasts, a type of immature cell not normally found in the blood. These cells don’t work the way they should.
People already known to have leukemia will have tests done to measure the amount of certain chemicals in the blood. These tests can help tell how well their kidneys and liver are working and if the blood is clotting as it should.
A doctor looks at the biopsy samples (bone marrow, blood, and cerebrospinal fluid) under a microscope. The doctor looks at the size and shape of the cells as well as other features to classify the cells into different types. An important goal of this process is to see whether the cells look mature. The number of blasts (immature cells) in the bone marrow is important in telling whether a person has leukemia.
Other lab tests
Other special tests can be used to look at the samples to help the doctor decide which type of leukemia a person has. You might hear some of the following terms:
- Flow cytometry
- Immunohistochemistry (IHC)
These are complex medical and chemical tests. Your doctor can tell you which of these might need to be done and why.
Imaging tests are ways of taking pictures of the inside of the body. Some of these tests might be done in people with leukemia. They are done most often to look for infections or other problems rather than to look for the leukemia itself.
Regular x-rays are not often needed in AML, but a chest x-ray might be done if the doctor thinks there could be a lung infection.
CT (computed tomography) scan
A CT scan uses x-rays to make detailed pictures of the inside of your body. This test can help tell whether any lymph nodes or organs in your body are swollen. This test is not often needed in people with AML.
MRI (magnetic resonance imaging) scan
Like CT scans, MRI scans make detailed pictures of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. MRI scans help look at the brain and spinal cord. But they are not often needed in people with AML.
Ultrasound uses sound waves to make pictures of organs inside your body. It can be used to look at lymph nodes near the surface of the body or to look for enlarged organs inside your belly, such as the kidneys, liver, and spleen.
Last Revised: 02/22/2016