Doctors use a variety of tests and screenings to diagnose acute myeloid leukemia (AML). If your doctor suspects you have leukemia, you’ll get a series of tests to determine the type and subtype. An accurate diagnosis is the first step toward the most effective treatment plan for you.

What are the subtypes of acute myeloid leukemia?

With other types of cancer, doctors use a staging system to identify how far the cancer has spread from the original tumor. With blood cancers such as AML, there isn’t a tumor. The cancer cells circulate in blood, so there is no way to stage the cancer. Instead of using cancer stages, your doctor will perform tests to determine the AML subtype. 

AML treatments vary depending on the subtype. These two factors also affect AML prognosis. Subtype diagnoses depend on:

• where the cancer starts (red blood cells, white blood cells, or platelets)

• potential cause, such as a genetic disorder or previous cancer treatments

• chromosomal abnormalities

• genetic mutations (changes)

• protein markers on the cancer cells

Diagnosing acute myeloid leukemia and subtypes

Your doctor will conduct a physical exam and review your symptoms and medical history. You may need one or more of these tests to diagnose AML and its subtype:

• Blood tests: A complete blood count (CBC) determines the number of platelets and red and white blood cells. You may also have a peripheral blood smear, which involves examining a blood sample under a microscope. A smear shows changes in the number of blood cells and how they look.

• Bone marrow tests: A bone marrow aspiration and biopsy can definitively diagnose (or rule out) AML. These tests identify leukemic blasts (abnormal cells) in bone marrow. Aspiration involves using a needle to draw out a small amount of liquid bone marrow for examination. During a biopsy, your doctor uses a slightly larger needle to remove a small piece of bone and bone marrow. These tests take place at the same time.

• Genetic tests: A genetic test identifies mutations, or changes, in genes that may cause AML.

• Spinal tap: Also called a lumbar puncture, this test checks for AML cells in the fluid surrounding the brain and spine. Your doctor may order this test to check whether the cancer has spread.

• Imaging scans: You may have X-rays, computed tomography (CT) scans, or another type of imaging scan to see if cancer has spread to organs or the spine.

From the community: “My mother had low platelets, and she has done bone marrow biopsy. We hadn't taken the results, but at first they told us that it wasn't leukemia. Two weeks after, she had a new blood test and the white blood cells (leukocytes) were 45,000. She was examined again, and we were told that it is acute myeloid leukemia (probably it is caused by chemo drugs and shots for cells).” - Inspire member

Sources

• Acute Myeloid Leukemia (AML) in Adults. American Cancer Society.

• Risk Factors for Acute Myeloid Leukemia (AML). American Cancer Society. August 2018.

• Acute Myeloid Leukemia. Leukemia and Lymphoma Society.

• Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version. National Cancer Institute. March 2020.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.