Acute Myeloid Leukemia

Overview

Acute myeloid leukemia, often called AML, is a type of blood cancer that starts in the bone marrow, the soft tissue inside bones where blood cells are made. In AML, immature white blood cells grow and multiply in an abnormal way. These abnormal cells can crowd out healthy blood cells, including red blood cells, normal white blood cells and platelets.

The word “acute” means that the condition can develop and progress quickly. For this reason, AML usually needs prompt medical assessment and treatment by a specialist team. AML can occur at any age, but it is more common in adults. The exact type and behavior of AML can vary from person to person, so diagnostic testing is important to guide care.

Symptoms

Symptoms of AML often develop because the bone marrow is not producing enough healthy blood cells. Some people may feel unwell for only a short time before diagnosis, while others may notice symptoms gradually.

• Persistent tiredness, weakness or low energy
• Shortness of breath during normal activities
• Pale skin
• Frequent or unusual infections
• Fever or night sweats
• Easy bruising or bleeding
• Nosebleeds or bleeding gums
• Small red or purple spots on the skin
• Bone or joint pain
• Unexplained weight loss or reduced appetite
• Swollen gums or a feeling of fullness in the abdomen in some cases

These symptoms can also be caused by many other conditions. However, because AML can progress quickly, persistent or unexplained symptoms should be checked by a healthcare professional.

Causes and Risk Factors

In many people with AML, the exact cause is not known. AML develops when genetic changes occur in immature blood-forming cells in the bone marrow. These changes affect how the cells grow, mature and die. The changes are usually acquired during a person’s lifetime rather than inherited from parents.

Some factors may increase the risk of developing AML, although having a risk factor does not mean a person will develop the disease.

• Increasing age
• Previous treatment with certain types of chemotherapy or radiation therapy
• Exposure to high levels of radiation or certain industrial chemicals
• Smoking
• Some blood disorders, such as myelodysplastic syndromes
• Certain inherited genetic conditions
• A family history of leukemia in rare situations

AML is not considered contagious and cannot be passed from one person to another through everyday contact.

Diagnosis

If AML is suspected, doctors usually begin with a medical history, physical examination and blood tests. A complete blood count can show abnormal levels of white blood cells, red blood cells or platelets. A blood smear may be examined under a microscope to look for immature or abnormal cells.

To confirm the diagnosis, a bone marrow test is usually needed. This involves taking a small sample of bone marrow for laboratory analysis. The sample is checked to identify leukemia cells and to understand their features.

Additional tests may be performed on blood or bone marrow samples. These can include genetic, chromosome and molecular tests. The results help doctors classify the type of AML, assess risk features and plan treatment. In some cases, imaging tests or tests of spinal fluid may be recommended, depending on symptoms and the medical situation.

Diagnosis and treatment planning are usually carried out by a hematology or oncology team with experience in blood cancers.

Treatment Options

Treatment for AML depends on several factors, including the person’s age, general health, AML subtype, genetic test results, previous treatments and personal preferences. Because AML can progress quickly, treatment often begins soon after diagnosis, once the necessary tests are complete.

Common treatment approaches may include intensive chemotherapy, lower-intensity therapy, targeted therapy when specific cell changes are present, and stem cell transplantation for selected patients. Supportive care is also an important part of treatment. This may include blood product support, infection prevention and management, and careful monitoring of side effects.

Some people may be treated in hospital, especially during intensive phases of care, while others may receive parts of treatment as an outpatient. The care team will explain the goals, possible benefits and risks of each option. Treatment plans may change over time depending on how the leukemia responds and how well the person tolerates therapy.

Clinical trials may be discussed in some cases. These are carefully monitored research studies that evaluate new or improved approaches to care. Participation is voluntary and should be explained clearly by the medical team.

When to See a Doctor

Seek medical advice if you have persistent tiredness, unexplained fever, frequent infections, unusual bruising or bleeding, or shortness of breath that is new or worsening. These symptoms do not always mean leukemia, but they should be evaluated.

Urgent medical attention is needed for heavy bleeding, difficulty breathing, chest pain, confusion, severe weakness, high fever, or signs of a serious infection. People who have already been diagnosed with AML should contact their healthcare team promptly if they develop fever, bleeding, new pain, worsening symptoms or any sudden change in their condition.

Early medical assessment helps ensure that the cause of symptoms is identified and that appropriate care can begin without unnecessary delay.