January 30, 2025

Acute Myeloid Leukemia

Navigating Acute Myeloid Leukemia: The Role of Hematopathology

Acute Myeloid Leukemia (AML) is an aggressive cancer that begins in the bone marrow and affects the production of blood cells. It is one of the most common types of leukemia in adults and will affect an estimated 20,800 people this year ¹.

Because of its many subtypes and genetic profiles, a multidisciplinary approach is necessary for the best outcomes.

Hematopathologists are trained to diagnose diseases of the blood cells, making this laboratory specialty vital to the diagnosis, treatment, and management of AML.


 

Diagnosis of AML

When a patient presents with symptoms that could indicate AML, such as fatigue, shortness of breath, bruising, bleeding, frequent infections, and/or abnormal laboratory tests, hematopathologists can assist in uncovering the underlying cause.

Advanced tests may be used to confirm the diagnosis, such as flow cytometry, cytogenetic analysis, fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR), and bone marrow biopsy. Hematopathologists meticulously analyze these test results to provide a precise diagnosis.


 

Treatment Planning

Once diagnosed, hematopathologists can help physicians create a treatment plan. Different subtypes of AML exist and hematopathology helps to identify these subtypes through techniques like immunophenotyping and cytogenetic analysis.

Understanding the subtype helps oncologists choose the most effective treatment regimen, which may include chemotherapy in combination with targeted therapies or stem cell transplantation. Management of AML is tailored based on factors such as the patient’s age, overall health, genetic profile of the leukemia, and response to initial therapy.

People whose leukemia cells have certain gene changes may have a better or worse outlook. For instance, AML with a variant in the FLT3, TP53, RUNX1, or ASXL1 genes tends to have a worse prognosis ². AML with a change in the NPM1 gene or both copies of the CEBPA gene tends to have a better outcome ².


 

Monitoring Response to Therapy

Throughout treatment, hematopathologists help monitor the patient’s response. Regular assessments and laboratory testing allow healthcare providers to evaluate the effectiveness of the chosen therapy. The results of these tests provide valuable insights into treatment efficacy and help in modifying the regimen if necessary. This close monitoring ensures that the patient receives the most appropriate care tailored to their response.

Treatment of AML is based on the subtype but usually involves two phases. The goal of the first phase is to kill the leukemia cells in the blood and bone marrow. This puts the leukemia into remission, which means that the signs and symptoms of cancer are reduced or have disappeared.

The second phase, known as post-remission therapy, is to prevent a relapse (return) of the cancer. It involves killing any remaining leukemia cells that may not be active but could begin to regrow.

Even after successful treatment, patients and their healthcare teams must remain vigilant. Hematopathologists continue to assist with monitoring patients during remission to detect any signs of relapse early on. Their expertise ensures that any recurrence is promptly addressed, maximizing the chances of successful re-treatment.


 

Choose HNL Lab Medicine for Your Lab Testing

HNL Lab Medicine has everything patients need, including an expert hematopathology team. An acute myeloid leukemia diagnosis is frightening, but you can trust in our hematopathologists to process your laboratory testing with diligence and care.

Their expertise, dedication, and precision saves lives and helps patients access the most appropriate treatments for their illness.

Rest easy knowing that at HNL Lab Medicine, we prioritize not just curing your illness but also offering heartfelt support and understanding throughout your treatment process.
 


 

REFERENCES
¹ American Cancer Society. (2024, January 17). Key statistics for acute myeloid leukemia (AML). https://www.cancer.org/cancer/types/acute-myeloid-leukemia/about/key-statistics.html.
² American Cancer Society. (2018, August 21). Acute myeloid leukemia (AML) subtypes and prognostic factors. https://www.cancer.org/cancer/types/acute-myeloid-leukemia/detection-diagnosis-staging/how-classified.html.
³ National Library of Medicine. (2023, November 27). Acute myeloid leukemia. National Institutes of Health. https://medlineplus.gov/acutemyeloidleukemia.html.