Acute myeloid leukaemia (AML) symptoms and tests

A full blood count (FBC) measures the number of each type of cell in the blood: red cells, white cells and platelets. You might be sent for this test by your GP as part of a routine check-up. Other patients might have one when they’re in hospital for something else.

If your FBC shows that you might have AML, you’ll need to go to hospital for more tests. If you’re diagnosed with AML, you’ll have regular FBCs to monitor your condition.

A blood film is also taken from a sample of your blood, which your doctor or hospital team use to look at your blood cells under a microscope. This allows them to see if you have any leukaemia cells in your blood.

In most cases, your doctor will also take a bone marrow sample to see how your blood is working inside your bone marrow.

There are two parts to your bone marrow test. You’ll have a bone marrow aspirate, which is where a sample of bone marrow is sucked out from your hip bone using a fine needle. Sometimes this is followed by taking a core of the marrow, using a different type of needle. The sample is also taken from the back of the hip. This test is known as a bone marrow trephine.

These tests can be done under local anaesthetic or with mild sedation to make you feel relaxed.

Bone marrow tests provide information about the structure of the marrow and the number and distribution of the different blood cell types – and cancer cells, if present. You might not have these tests if active treatment isn’t appropriate for you. Your doctor will talk to you about this if it’s the case.

Find out more about how bone marrow tests are done.

Several laboratory tests are done on your blood and bone marrow samples that you’ve given. The hospital team will look at the cells under a microscope. They’ll test whether the cells are leukaemia cells by a technique called immunophenotyping, which counts the number of leukaemia cells and determines whether these cells are myeloid or lymphoid cells.

This test can tell your doctors the type of acute leukaemia you have – so whether you have AML, acute lymphoblastic leukaemia (ALL), or acute promyelocytic leukaemia (APL).

Leukaemia is caused by genetic errors. Sometimes this happens on a greater scale, which is easy to see under the microscope.

Genes are arranged into structures called chromosomes. We have 46 chromosomes, which can sometimes be broken or rearranged. The hospital team will look to see if this has happened. The study of this is called cytogenetics.

Genetic information from testing helps your healthcare team decide on suitable treatment options, which they’ll discuss with you. Sometimes you might have more genetic tests, but not all people have them.