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Acute Myeloid Leukemia
Diagnosis

First, your doctor will perform a physical examination and look for swelling in the liver, spleen, groin, neck and lymph nodes under your arm.

Your doctor will order a CBC test, which is a complete blood count that measures the amount of white and red blood cells and platelets in your blood. In addition, a sample of your blood is examined under a microscope to see what the cells look like and to determine the number of mature cells as well as leukemia cells, called blasts. Although blood tests may reveal that a patient has leukemia, they do not always indicate the type of leukemia.

In order to further check for leukemia cells or to identify what type of leukemia a patient has, a hematologist (blood disorder specialist) or oncologist (cancer specialist) performs a bone marrow aspiration and biopsy. During this procedure, the doctor inserts a needle into a large bone (usually the hip or back pelvis) and removes a small amount of liquid bone marrow (aspiration) and a piece of the spongy tissue inside the bone (biopsy).

The procedure takes about 20 minutes. Once the biopsy and aspiration are obtained the hematologist, oncologist or pathologist examines the samples under the microscope.

AML is diagnosed when the bone marrow contains 20 percent or more immature cells called blasts — a normal bone marrow has less than 5 percent blasts — determined to be myeloid in nature.

Additional tests are performed to confirm the diagnosis and reveal the exact AML subtype. In addition, a small amount of the liquid bone marrow is sent for a special chromosome test called cytogenetics, which can sometimes reveal important information regarding treatment and prognosis.

Reviewed by health care specialists at UCSF Medical Center.