What other blood tests are helpful to collect if you suspect an AML diagnosis? What other blood tests are necessary if you suspect AML? You're looking at blood counts, of course. That's the enumeration of white cells, hemoglobin platelets. Typically, in acute leukemia, the platelets are low because the normal cells, normal stem cells cannot function and they don't produce enough platelets. Platelets do blood clotting. They don't produce enough red cells, so patients become anemic. That means the hemoglobin goes down. Some patients have very high white count and some patients have very low white count. All these years, this is not fully understood what regulates it. The first thing we do is a CBC, a complete blood count with platelets. We will also look in a microscope and see what kinds of cells do we see. The next step is chemistry. We want to make sure the liver is intact, the kidneys are intact, the electrolytes are okay, because when we start killing leukemic cells, they get broken down and excreted to the kidneys and liver. We want to make sure that these organs are in good shape and we can help preventing a pileup of products from these huge numbers of leukemic cells that we kill in a few days frequently. Blood chemistry is typical. We do EKGs to make sure cardiac situation is okay. Of course, we do a chest X-ray to see if there are any signs of pneumonia. We're looking at the heart. These are the major tests. Sometimes we are doing a spinal tap to make sure that there are no leukemic cells in the spinal fluid. That can be a reservoir of leukemic cells later. If they are present, we will treat the leukemia in the spinal fluid with additional chemotherapy that's injected into the spinal canal in the back. This has been critical in curing acute lymphoid leukemias. Now that we have much higher response rates and much better survival in myeloid leukemias, this becomes an increasingly important issue. We want to make sure there are no cells hidden from chemotherapy or from targeted therapy in the spinal fluid.
