Once adult AML has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body. The extent or spread of cancer is usually described as stages. In adult acute myeloid leukemia (AML), the subtype of AML and whether the leukemia has spread outside the blood and bone marrow are used instead of the stage to plan treatment. The following tests and procedures may be used to determine if the leukemia has spread:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.
• Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs in the abdomen and make echoes. The echoes form a picture of body tissues called a sonogram.

There is no standard staging system for adult AML. The disease is described as untreated, in remission, or recurrent.

• Untreated adult AML
In untreated adult AML, the disease is newly diagnosed. It has not been treated except to relieve symptoms such as fever, bleeding, or pain and the following are true:
• The complete blood count is abnormal.
• More than 30% of the cells in the bone marrow are blasts (leukemia cells).
• There are signs or symptoms of leukemia.

• Adult AML in remission
In adult AML in remission, the disease has been treated and the following are true:
• The complete blood count is normal.
• Less than 5% of the cells in the bone marrow are blasts (leukemia cells).
• There are no signs or symptoms of leukemia in the brain and spinal cord or elsewhere in the body.

• Recurrent Adult Acute Myeloid Leukemia
Recurrent adult acute myeloid leukemia (AML) is cancer that has recurred (come back) after it has been treated. The AML may come back in the blood or bone marrow.