A fever, shortness of breath, and unusual bruising or bleeding could be signs of acute myeloid leukemia (AML). If you have any of these symptoms, see your doctor.
Your family doctor might refer you to an oncologist or hematologist -- specialists who diagnose and treat leukemia. The doctor will do tests to find out if you have AML and which type you have. The more your doctor knows about your cancer, the greater the odds that your treatment will be successful.
At your visit, your doctor will ask questions about your health. During the exam, your doctor will check your body for signs of cancer, such as bruises or spots of blood under your skin.
Tests for AML
AML affects immature blood cells called stem cells that grow into white blood cells, red blood cells, and platelets. These blood cells are made in your bone marrow -- the spongy material inside your bones. In AML, the stem cells are abnormal and can't grow into healthy blood cells.
These tests look for immature or abnormal cells in your blood and bone marrow:
- Blood tests
- Bone marrow tests
- Lumbar puncture
- Imaging tests
- Gene tests
During a blood test, your doctor uses a needle to take a sample of blood from a vein in your arm. Doctors use different types of blood tests to diagnose AML:
- Complete blood count (CBC). This test checks how many white blood cells, red blood cells, and platelets you have. With AML, you may have more white blood cells and fewer red blood cells and platelets than normal.
- Peripheral blood smear. In this test, a sample of your blood is examined under a microscope. It checks the number, shape, and size of white blood cells, and looks for immature white blood cells called blasts.
Bone Marrow Test
To confirm that you have AML, you'll also need a bone marrow test. The doctor will place a needle into a bone -- usually near your hip -- and remove a little bit of fluid or a small piece of bone.
The sample will go to a lab for testing. A doctor called a pathologist will look at your cells under a microscope. If 20% or more of the blood cells in your bone marrow are immature, you may be diagnosed with AML.
Lumbar Puncture (Spinal Tap)
This test uses a needle to remove a small sample of cerebrospinal fluid (CSF), the fluid that surrounds your brain and spinal cord. The CSF is examined under a microscope to see if it contains leukemia cells.
Imaging tests use radiation, sound waves, and magnets to make pictures inside your body. AML doesn't form tumors that show up on scans, but your doctor might use these tests to look for an infection or another problem AML can cause.
These imaging tests can help your doctor diagnose AML:
CT, or computed tomography. This powerful X-ray makes detailed pictures inside your body. A CT scan can show whether AML has enlarged your spleen or lymph nodes. You might get a special dye by mouth or into a vein before the test. This dye helps your doctor see your organs more clearly on the scan.
Ultrasound. It uses sound waves to see whether your lymph nodes, liver, spleen, and kidneys are enlarged.
X-ray. It uses radiation in low doses to make images of structures inside your body. Your doctor might take X-rays to see if you have a lung infection.
There are several forms of AML. Your doctor can find out which one you have by looking for gene changes in a sample of your blood or bone marrow. This can help your doctor find the treatment that is most likely to work on your cancer.
These tests include:
Cytogenetic analysis looks for chromosome changes in your cells. Chromosomes are stretches of DNA. Sometimes in AML, two chromosomes switch DNA. This is called a translocation.
Immunophenotyping tests look for substances called markers on the surface of leukemia cells. Different types of AML cells have their own unique markers.
Fluorescent in situ hybridization (FISH) looks for abnormal chromosomes in your cells using special dyes that attach to certain parts of the chromosome.
Polymerase chain reaction (PCR) uses chemicals to find changes in genes.