Diagnosing

Pediatric Acute Myelogenous Leukemia (AML)


Diagnosing Pediatric AML (Acute Myelogenous Leukemia)

At Sheba Medical Center, a team of experienced medical oncologists, hematologists, and pathologists will assess your case closely to diagnose and determine the subtype of your disease. We are dedicated to providing the best care to patients with AML from before diagnosis all the way through treatment and follow-up.

We aim to keep you informed every step of the way as our specialists guide you through the critical diagnostic part of your cancer care. Once a diagnosis is made, we come up with an individualized treatment plan tailored to your specific needs.

During your diagnostic evaluation at Sheba, we may perform the following procedures:

 

Complete blood count (CBC) and peripheral blood smear.

A CBC is a blood test that analyzes the count of red blood cells, white blood cells, and platelets in the blood. A peripheral blood smear is a laboratory test that involves examining the blood under a microscope for changes in the number and appearance of cells.

 

Bone marrow aspiration and biopsy.

Leukemia starts in the bone marrow, which makes analyzing and testing a bone marrow sample an essential part of AML diagnosis. A bone marrow aspiration involves taking a sample of liquid bone marrow with a long, thin needle. During a bone marrow biopsy, a small piece of bone and marrow are removed and sent to the lab for testing. These procedures are performed at the same time.

 

Lumbar puncture.

Since AML can spread to the central nervous system (brain and spinal cord), doctors may remove a sample of cerebral spinal fluid (CSF) for testing.

 

Cytochemistry.

In this laboratory test, cells are exposed to a dye that only reacts with leukemia cells. The color changes in the cells indicate whether they are cancerous and if so, which type of leukemia it is.

 

Flow cytometry and immunohistochemistry.

This laboratory test uses a sample of cells that are treated with antibodies that only attach to certain proteins on the cells. This helps to determine exactly which type of leukemia a person has.

 

Chromosome tests.

Leukemia cells sometimes exhibit chromosomal changes that can help specialists identify the type of AML and the best course of treatment moving forward.

 

Fluorescent in situ hybridization (FISH).

This laboratory test uses fluorescent dyes that attach to certain genes or chromosomes. It can pick up on small changes that are not seen in other kinds of testing.

 

Imaging tests.

Since leukemia doesn’t form tumors, imaging tests are not usually helpful in making a diagnosis. However, they may be used during the diagnostic part of your care to identify infection or determine the extent of your disease if doctors believe that it has spread. Imaging tests that may be used include x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound (US), positron emission tomography (PET) scans, and bone scans.

 

Prognostic Factors.

Leukemia does not form tumors the way other types of cancer do, and therefore is not staged. The outlook for a person with AML depends on many factors, including:

  • AML subtype
  • Age of the patient
  • Laboratory test results
  • Levels of leukemia cells in the CSF
  • Genetic mutations in the cells
  • White blood cell count at the time of diagnosis
  • Prior blood disorder
  • Response to the first cycle of chemotherapy treatment

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