How is it Diagnosed?
Acute Myeloid Leukemia (AML) is a rapidly progressing cancer of the myeloid line of
blood cells. Diagnosis begins with a clinical assessment of symptoms like fatigue,
bleeding, frequent infections, and anemia. A complete blood count (CBC) often shows
anemia, thrombocytopenia, and the presence of immature white cells (blasts).
Peripheral blood smear typically reveals a high number of myeloblasts. However,
definitive diagnosis requires a bone marrow aspiration and biopsy, which demonstrates
hypercellularity with >20% blasts, the hallmark of AML. Cytochemical stains such as
myeloperoxidase and Sudan Black B help differentiate AML from other leukemias.
Flow cytometry is employed to determine immunophenotype and confirm the myeloid
origin of blasts. Cytogenetic and molecular testing, including FISH and PCR, identify
chromosomal abnormalities (e.g., t(8;21), inv(16), FLT3 mutation) critical for prognosis and
treatment planning.
Additional tests include coagulation profile to evaluate for disseminated intravascular
coagulation (DIC), especially in acute promyelocytic leukemia (APL) subtype. Liver and
renal function tests, uric acid, and LDH levels are checked to monitor organ function
and tumor lysis risk.
Early diagnosis is essential due to the aggressive nature of AML and the need for
prompt initiation of chemotherapy.