Investigations

The following tests/procedures are carried out as the initial work up of a patient with AML:

Tests required to establish the diagnosis include:

• complete blood counts and differential count
• bone marrow aspirate - marrow blast count of 20% or more is required
• immunophenotyping
• cytogenetics

Additional tests/procedures which are carried out at diagnosis are:

• demographics and medical history
• performance status (ECOG/WHO score)
• analysis of comorbidities
• biochemistry - glucose, sodium, potassium, calcium, creatinine, aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase, lactate dehydrogenase, bilirubin, urea, total protein, uric acid
• coagulation tests - prothrombin time (PTT), international normalized ratio (INR) if indicated, activated partial thromboplastin time (aPTT).
• urine analysis - pH, glucose, erythrocytes, leukocytes, protein, nitrite.
• serum pregnancy test - in women of childbearing age
• hepatitis A, B, C; HIV-1 testing
• chest x-ray, 12-lead ECG; echocardiography (if indicated)

Reference:

• (1) Döhner H et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood. 2010;115(3):453-74.