Recommended tests and procedures in the initial workup of pediatric patients with AML
| Test/procedure . | Rationale . |
|---|---|
| Tests to establish the diagnosis | |
| Complete blood counts and differential count | Diagnosis, initial risk |
| Bone marrow aspirate | Diagnosis |
| Bone marrow trephine biopsy* | Diagnosis |
| Lumbar puncture† | Diagnosis, treatment, prognosis |
| Immunophenotyping | Diagnosis |
| Cytogenetics | Diagnosis, treatment, prognosis |
| Molecular genetics/translocations/mutations (see Table 4) | Diagnosis, treatment, prognosis |
| Additional tests/procedures at diagnosis | |
| Demographics and medical history‡ | Initial risk |
| Performance status (WHO score) | Initial risk |
| Physical examination | Diagnosis, side effects |
| Syndromes, comorbidities | Treatment, prognosis |
| Biochemistry, coagulation tests§ | Initial risk |
| Serum pregnancy test‖ | Treatment |
| Hepatitis A, B, C; CMV, EBV, VZV, blood group Rh¶ | Diagnosis, side effects |
| Chest x-ray, 12-lead, electrocardiography (ECG); echocardiography | Diagnosis, side effects |
| Test/procedure . | Rationale . |
|---|---|
| Tests to establish the diagnosis | |
| Complete blood counts and differential count | Diagnosis, initial risk |
| Bone marrow aspirate | Diagnosis |
| Bone marrow trephine biopsy* | Diagnosis |
| Lumbar puncture† | Diagnosis, treatment, prognosis |
| Immunophenotyping | Diagnosis |
| Cytogenetics | Diagnosis, treatment, prognosis |
| Molecular genetics/translocations/mutations (see Table 4) | Diagnosis, treatment, prognosis |
| Additional tests/procedures at diagnosis | |
| Demographics and medical history‡ | Initial risk |
| Performance status (WHO score) | Initial risk |
| Physical examination | Diagnosis, side effects |
| Syndromes, comorbidities | Treatment, prognosis |
| Biochemistry, coagulation tests§ | Initial risk |
| Serum pregnancy test‖ | Treatment |
| Hepatitis A, B, C; CMV, EBV, VZV, blood group Rh¶ | Diagnosis, side effects |
| Chest x-ray, 12-lead, electrocardiography (ECG); echocardiography | Diagnosis, side effects |
Table 3 is analogous to the table of Döhner et al.4
Mandatory in patients with a dry tap (punctio sicca) and in case of dysplasia in the peripheral blood or bone marrow, or in the differentiation from MDS.
Required in all patients. Patients with clinical symptoms of suspected CNS involvement should be evaluated by imaging study for intracranial bleeding, leptomeningeal disease, and mass lesion; lumbar puncture should be postponed or is considered optional in other settings (eg, high WBC count or APL).
Includes race or ethnicity, family history, prior exposure to toxic agents, prior malignancy, therapy for prior malignancy, and information on smoking.
Biochemistry: sodium, potassium, calcium, phosphate, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, bilirubin, and uric acid; on indication, add other tests. Coagulation tests: prothrombin time (PTT), international normalized ratio (INR) where indicated, and activated partial thromboplastin time (aPTT).
In adolescents (female) of child-bearing potential.
Additional tests may be considered (eg, HIV-1, Parvo B19, and HLA typing).