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]

Overview

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

Other Diagnostic Studies

Cytochemistry

• This is a test used to differentiate acute myeloid leukemia from acute lymphoblastic leukemia
• Using 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

• In these tests special antibodies are used to detect cancer cells and thus to differentiate acute myeloid leukemia from other leukemias.

Immunophenotyping

• MoAb to megakaryocyte restricted antigen (CD41 and CD61) may be diagnostic for patients with acute megakaryoblastic leukemia.

PCR

• PCR is a highly sensitive DNA test used to recognize cancer cells in acute myeloid leukemia.

Biopsy

• 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 the presence of leukemia, to differentiate acute myeloid leukemia from other types of leukemia (e.g. acute lymphoblastic leukemia), and to classify the subtype of disease. A sample of marrow or blood is typically also tested for chromosomal translocations by routine cytogenetics or fluorescent in situ hybridization.

Acute megakaryoblastic leukemia

• Diagnosis requires more than 20% blasts in the marrow/ peripheral blood
• More than 50% demonstrating megakaryocytic derivation