Acute myeloid leukemia other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Raviteja Guddeti, M.B.B.S. [2], Carlos A Lopez, M.D. [3], Shyam Patel [4]; Grammar Reviewer: Natalie Harpenau, B.S.[5]

## Overview[edit | edit source]

Other diagnostic studies for acute myeloid leukemia include cytochemistry, flow cytometry, immunohistochemistry, PCR and biopsy.

## Other Diagnostic Studies[edit | edit source]

### Cytochemistry[edit | edit source]

* This is a test used to differentiate acute myeloid leukemia from acute lymphoblastic leukemia.
* This test uses a stain which reacts to a particular type of leukemic cells.
* The stain causes the granules of most acute myeloid leukemia cells to appear as black spots under the microscope, but it does not cause acute lymphoblastic cells to change colors.

### Flow cytometry and immunohistochemistry[edit | edit source]

* In these tests special antibodies are used to detect cancer cells and thus to differentiate acute myeloid leukemia from other leukemias.
* Monoclonal antibody binding to specific antigens, such as CD33 or CD117, are helpful in the diagnosis of acute myeloid leukemia.
* Sufficient sample must be present in order for these tests to be reliable.

### Polymerase chain reaction[edit | edit source]

* Polymerase chain reaction is a highly sensitive DNA test used to recognize cancer cells in acute myeloid leukemia, especially for detection of minimal residual disease testing or for molecular mutation assessment. Next-generation sequencing is becoming an increasingly important diagnostic test.

### Bone marrow biopsy[edit | edit source]

* Bone marrow examination is often performed to identify the type of abnormal blood cells; however, if there are many leukemic cells circulating in the peripheral blood, a bone marrow biopsy may not be necessary.
* Bone marrow is examined via light microscopy as well as flow cytometry to diagnose acute myeloid leukemia, to differentiate acute myeloid leukemia from other types of leukemia (e.g. acute lymphoblastic leukemia), and to classify the sub-type of disease. A sample of marrow or blood is typically also tested for chromosomal translocations by routine cytogenetics or fluorescent in situ hybridization.[1]

* Lumber puncture: Assessment of the cerebrospinal fluid (CSF) can be done via lumbar puncture. This diagnostic study is especially useful for patients with acute myeloid leukemia who have neurologic deficits, as this is concerning for central nervous system involvement. The cell count from the cerebrospinal fluid will show malignant myeloid cells (typically greater than 2 cells per microliter of cerebrospinal fluid). Treatment of cerebrospinal fluid involvement includes methotrexate, hydrocortisone, and cytarabine.[2]

## References[edit | edit source]

1. ↑ Percival ME, Lai C, Estey E, Hourigan CS (2017). "Bone marrow evaluation for diagnosis and monitoring of acute myeloid leukemia". Blood Rev. 31 (4): 185–192. doi:10.1016/j.blre.2017.01.003. PMC 5513766. PMID 28190619.CS1 maint: Multiple names: authors list (link)
2. ↑ Montesinos P, Díaz-Mediavilla J, Debén G, Prates V, Tormo M, Rubio V; et al. (2009). "Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis". Haematologica. 94 (9): 1242–9. doi:10.3324/haematol.2009.007872. PMC 2738716. PMID 19608685.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

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Myeloid Hematological malignancy/leukemia histology (ICD-O 9590-9989, C81-C96, 200-208)

CFU-GM/
and other granulocytes|

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MEP|

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CFU-Mast|

Mastocytoma (Mast cell leukemia, Mast cell sarcoma, Systemic mastocytosis)

Multiple/unknown|

AML (Acute panmyelosis with myelofibrosis, Myeloid sarcoma) * MP (Myelofibrosis) * Acute biphenotypic leukaemia

See also hematology, lymphoid malignancy

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