Acute Myelocyctic Leukemia Diagnosis

Initial Diagnosis of Leukemia

Like all cancers acute leukemias are best treated when it is diagnosed early. However, no screenings methods have been found to detect the presence of leukemias. Therefore, mostly a thorough diagnostic examinations is performed due to the determine whether the acute myelocytic leukemias is present or not.

The first time someone is suspected by leukemias, a diagnosis is started by observing medical records of the patients. Physical examination in particular in the area of neck, underarm, and pelvic region to determine the presence of enlarged lymph nodes is conducted. Then, internal examinations are checked in the swollen gums, enlarged liver or spleen, bruises, or pinpoint red rashes all over the body as these symptoms could be the indicators of the acute leukemias. In addition, the physician may examine the teeth and look for dental abscesses, may explore whether back pain is present.

Urine and blood tests may be ordered to check for microscopic amounts of blood in the urine and to obtain a complete differential blood count. This count will give the numbers and percentages of the different cells found in the blood. An abnormal blood test might suggest leukemia. Patients suffering from AML may have high leukocyte counts and typically have low counts of both red blood cells and platelets. Many patients with AML have low counts of all of the major components of the blood will usually show that leukemic blast cells are present. However, the diagnosis has to be confirmed by more specific tests.

Laboratory Examination of Leukemia

The doctor may perform a bone marrow aspiration and biopsy to confirm the diagnosis of leukemia. Aspiration involves the withdrawal of a liquid sample of marrow. During the biopsy, a cylindrical piece of bone and marrow is removed. The tissue is generally taken out of the hipbone. These samples are sent to the laboratory for examination. In addition to diagnosis, the aspiration and biopsy may be repeated during the treatment phase of the disease to see if the leukemia is responding to therapy.

A chest photographic image is taken. Cardiac tests, including an electrocardiogram, are conducted too. The patient is examined for possible infection. These diagnostic procedures often disclose bleeding in the stomach or intestines, and there may be bleeding in the lungs, brain, or eyes. Anemia is often present and may be severe.

Sophisticated cytogenetic studies, which examine the number and shape of the chromosomes in the DNA of individual blast cells, should be conducted in addition to the immunophenotyping of cells of the bone marrow. This procedure involves applying various stains to the marrow cells. These stains help doctors identify some of the proteins lying on the surface of the cells.

A spinal tap (lumbar puncture) is another procedure the doctor may order to diagnose leukemia. In this procedure, a small is inserted into the spinal cavity in the lower back to withdraw some cerebrospinal fluid and to look for leukemic cells. Routine screening with lumbar puncture is no warranted in AML patients at the time of diagnosis, however.

Standard imaging tests such x-rays may be performed to check whether the leukemic cells have invaded other areas of the body, such as the bones, chest, kidneys, abdomen, or brain. Other tests, such as computed tomography scans (CT scans), magnetic resonance imaging (MRI), or gallium scans, are not typical for acute myelocytic leukemia, but they may be also performed. Both children and adults are examined exactly.