Diagnosis and Classifications of Pediatric AML

Correct diagnosis is key to successful treatment of acute myeloid leukemia (AML). This chapter describes the development of classification of pediatric AML, the most recent classification according to the World Health Organization, and how to diagnose AML. The basis for the initial bone marrow examination is morphological evaluation of bone marrow smear with or without trephine biopsy. Flow cytometry immunophenotyping is used to confirm AML and allow for treatment start. Information about genetic abnormalities in the leukemic cells is needed for complete diagnosis, evaluation of the risk of relapse for decision regarding allogeneic stem cell transplantation, if targeted treatment can be given, and if there is genetic predisposition. In this chapter, morphological assessment, immunophenotyping, cytogenetics, and molecular genetic techniques including next generation sequencing are described.