Acute Myeloid Leukaemia (AML) may be suspected on a simple blood test called a Full Blood Count (FBC) and a blood film that is examined under a microscope. The diagnosis is made by examining a sample of bone marrow – further analysis of the sample provides information on the specific sub-type of AML, helps to determine which further treatments may be needed and gives information about prognosis.
The bone marrow biopsy procedure itself is in two parts that are undertaken concurrently by the specialist Doctor or Nurse. A local anaesthetic is given around the back of the hipbone when you are lying on your side - after giving this time to numb the area, the procedure will begin. The bone marrow aspirate will take a sample of fluid extracted via a syringe and needle - this is spread on glass slides (to examine under the microscope) and placed in sample bottles that will be sent to the specialist laboratory. There will also be a core of the bone marrow taken with a larger bore needle. This is called a trephine biopsy and is examined by microscopy. Both the aspirate and trephine are important for diagnosis and assessment of disease response.
Cytogenetic (chromosomal) and molecular DNA tests are carried out on blood and bone marrow samples to identify the genetic makeup of the leukaemia cells. There are many specific genetic variations that can occur in AML, and knowing the exact type of AML you have can help doctors decide the most appropriate treatment.