n HOW MANY CHILDREN DEVELOP AML? Each year in the United States, there are approximately 4,900 new cases of all types of leukemia diagnosed in people age 20 years and younger. Of these children, adolescents, and young adults who have leukemia, approximately 15%–20%—or about 1 in 5—will be diagnosed with AML. This is roughly 730 cases of AML each year in people age 20 years and younger. n WHERE IS AML FOUND IN THE BODY? AML begins in the bone marrow and travels into the peripheral blood (circulating bloodstream). In some children, it also can be found in the cerebral spinal fluid (the fluid that surrounds the brain and spinal cord). AML may develop under the surface of the skin and appear as subcutaneous nodules (or raised lesions on the skin). In rare instances, the leukemia cells clump together, forming a mass or tumor. These tumors are referred to as chloromas. n WHAT TESTS AND PROCEDURES WILL MY CHILD NEED? Blood Tests Blood tests are done to monitor your child’s blood cells and body chemistries. The complete blood count (known as a CBC) is used to detect anemia (low hemoglobin or hematocrit, a measure of low RBCs), detect changes in WBCs (infection-fighting cells), and detect changes in platelets (cells that help the blood clot). The percentage of leukemia blasts or immature WBCs also is assessed. A chemistry panel will look at your child’s electrolytes (salt and sugar levels) and liver and kidney function.
Bone Marrow Aspiration and Biopsy Bone marrow aspiration and biopsy are the primary tests used in the diagnosis of leukemia. These tests determine whether leukemia cells are present in the bone marrow (the blood-producing factory of the body). Bone marrow aspiration involves inserting a special needle into one of the bones (usually the front or back part of the hip bone) and drawing some bone marrow into a syringe. It sometimes is necessary to obtain bone marrow from both the right and left hip bones. Another part of this test involves taking a small piece of the bone marrow to examine for leukemia cells. This is referred to as a bone marrow biopsy. Bone marrow aspiration and biopsy are the only ways to positively determine whether leukemia cells are in the bone marrow. This test helps the physician determine the type of leukemia and choose
proper treatment for your child. Sedation medication or sometimes general anesthesia will be used to help your child remain still and to prevent or minimize discomfort during the procedure. Your child may experience some mild discomfort after the procedure, which usually is relieved with a mild pain reliever such as acetaminophen. However, discuss the use of any medication with your child’s physician or healthcare provider prior to use.
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