Childhood Acute Myeloid Leukemia, Part 2

by National Cancer Institute

(Page 2 of 5)

The symptoms of TMD may include the following:

• Swelling all over the body.
• Shortness of breath.
• Trouble breathing.
• Weakness or feeling tired.
• Pain below the ribs.

Tests that examine the blood and bone marrow are used to detect (find) and diagnose childhood AML, childhood CML, JMML, TMD, and myelodysplastic syndromes.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:

• The number of red blood cells, white blood cells, and platelets.
• The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
• The portion of the sample made up of red blood cells.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Peripheral blood smear: A procedure in which a sample of blood is checked for blast cells, number and kinds of white blood cells, number of platelets, and changes in the shape of the blood cells.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. Biopsies that may be done for childhood AML include the following:

• Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or breastbone.
• Tumor biopsy: A biopsy of a chloroma may be done.
• Lymph node biopsy: The removal of all or part of a lymph node.

Cytogenetic analysis: A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes.

Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell, that may include special staining of the blood and bone marrow cells. This process is used to diagnose the subtype of AML by comparing the cancer cells to normal cells of the immune system.

Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options for childhood AML depend on the following:

• Number of white blood cells in the blood at diagnosis
.
• Whether the AML was caused by previous anticancer treatment.
• The subtype of AML.
• Whether there are certain chromosomal changes in the leukemia cells.
• Whether the child has Down syndrome. Most children with AML and Down syndrome can be cured of their leukemia
• How well the leukemia responds to initial treatment.
• Whether the AML is newly diagnosed or has recurred (come back) after being treated.
• The length of time since treatment ended, for AML that has recurred.

The prognosis and treatment options for childhood CML depend on how long it has been since the patient was diagnosed and how many blast cells are in the blood.

The prognosis (chance of recovery) and treatment options for JMML depend on the following:

• The age of the child at diagnosis.
• How many red blood cells, white blood cells, or platelets are in the blood.
• Whether the JMML is untreated or has recurred after treatment.

The prognosis (chance of recovery) and treatment options for myelodysplastic syndromes depend on the following:

• Whether the myelodysplastic syndrome was caused by previous cancer treatment.
• How low the numbers of red blood cells, white blood cells, or platelets are.
• Whether the myelodysplastic syndrome is untreated or has recurred after treatment.

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