Acute Myeloid Leukemia (AML)
What is Acute Myeloid Leukemia (AML)?
Acute myeloid leukemia is a blood cancer that starts in the bone marrow. The bone marrow is the soft inner part of your bones where blood cells are made. In AML, the bone marrow makes abnormal immature white blood cells called blasts. These blasts multiply quickly and crowd out healthy blood cells.
When blasts take over the bone marrow, your body cannot make enough normal blood cells. This leads to low red blood cells, low platelets, and abnormal white blood cells. Red blood cells carry oxygen, platelets help blood clot, and white blood cells fight infection. Without enough healthy cells, you may feel tired, bleed easily, and get infections.
AML is called acute because it develops quickly and needs treatment right away. It is different from chronic leukemia, which grows slowly over months or years. AML can happen at any age but is most common in adults over 65. Early detection through blood testing can help guide treatment decisions and improve outcomes.
Symptoms
- Fatigue and weakness that does not improve with rest
- Fever or night sweats without an obvious infection
- Easy bruising or small red spots on the skin called petechiae
- Bleeding that is hard to stop, including nosebleeds or bleeding gums
- Frequent infections that may be severe
- Bone or joint pain, especially in the arms and legs
- Shortness of breath during normal activities
- Pale skin from low red blood cell count
- Loss of appetite or unintended weight loss
- Swollen lymph nodes, liver, or spleen
Some people with early AML may have mild symptoms that seem like the flu. Others feel very sick quickly. Blood test changes often appear before symptoms become severe.
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Causes and risk factors
AML happens when DNA changes in bone marrow cells cause them to grow out of control. Most cases occur without a clear cause. Age is the biggest risk factor, with most cases diagnosed after age 65. Previous chemotherapy or radiation therapy for other cancers can damage bone marrow and increase AML risk years later. Exposure to high levels of benzene, a chemical found in cigarette smoke and some industrial settings, also raises risk.
Some people have genetic conditions that make AML more likely. These include Down syndrome, Fanconi anemia, and other inherited bone marrow disorders. Having a blood disorder like myelodysplastic syndrome can progress to AML over time. Smoking cigarettes increases risk because tobacco smoke contains benzene and other chemicals that damage bone marrow. Family history of AML is rare but can play a role in some cases.
How it's diagnosed
Doctors diagnose AML using blood tests and bone marrow tests. A complete blood count measures your red blood cells, white blood cells, and platelets. In AML, you may have low platelet counts, abnormal neutrophil counts, or abnormal white blood cells. Low platelets happen because leukemia blasts crowd the bone marrow and prevent normal platelet production. Neutrophil counts may be very low, very high, or show abnormal cell shapes.
If blood tests show abnormal results, your doctor will order a bone marrow biopsy. This test takes a small sample of bone marrow to look for leukemia blasts under a microscope. Doctors also do genetic tests on the leukemia cells to guide treatment choices. Rite Aid offers blood testing that measures platelet count and neutrophils at Quest Diagnostics locations nationwide. Regular monitoring of these biomarkers helps track treatment response and detect changes early.
Treatment options
- Chemotherapy to kill leukemia cells, usually given in the hospital over several weeks
- Stem cell transplant to replace diseased bone marrow with healthy cells
- Targeted therapy drugs that attack specific genetic changes in leukemia cells
- Blood transfusions to replace red blood cells and platelets during treatment
- Antibiotics and antifungal medications to prevent and treat infections
- Growth factors to help the bone marrow recover and make healthy white blood cells
- Supportive care including nutrition support, pain management, and emotional support
- Clinical trials testing new treatments for patients who qualify
Treatment for AML is intense and requires close monitoring by a cancer specialist called a hematologist-oncologist. Regular blood tests during treatment track how well the bone marrow is recovering. Most patients need to stay in the hospital during initial chemotherapy. After treatment ends, frequent follow-up blood tests watch for signs of the cancer returning.
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Frequently asked questions
The first signs often include feeling very tired, getting fevers without infection, and bruising easily. Many people notice they bleed longer than normal from small cuts. Some people develop frequent infections or bone pain. These symptoms happen because abnormal cells crowd out healthy blood cells in your bone marrow.
AML grows quickly and needs treatment right away, while chronic leukemias grow slowly over years. AML starts in myeloid cells that normally become red blood cells, platelets, or certain white blood cells. Other leukemias like ALL start in lymphoid cells. Each type needs different treatment approaches based on which cells are affected.
Yes, blood tests often show the first signs of AML before symptoms become severe. A complete blood count may reveal low platelet counts and abnormal white blood cell counts. Neutrophils may be very low, very high, or look abnormal under the microscope. If blood tests show concerning changes, doctors order bone marrow tests to confirm the diagnosis.
Leukemia blasts fill up the bone marrow and block normal platelet production. The bone marrow cannot make enough healthy platelets when cancer cells take over the space. Low platelet counts increase bleeding risk and are often one of the first blood test changes seen in AML. Monitoring platelet levels helps doctors assess disease severity and treatment response.
AML disrupts normal white blood cell production in the bone marrow. Some patients develop very low neutrophil counts because leukemia blasts crowd out healthy cells. Others have high counts with abnormal or immature neutrophils that do not work properly. Neutrophil abnormalities are part of how doctors diagnose AML and track treatment progress.
Some patients achieve long-term remission and are considered cured, especially younger patients who respond well to treatment. Cure rates depend on age, overall health, genetic features of the leukemia, and how well it responds to chemotherapy. Stem cell transplant offers the best chance for cure in many cases. Older adults and those with high-risk genetic changes face more challenges.
People with known risk factors like previous chemotherapy or blood disorders should get regular blood counts. Your doctor will recommend a testing schedule based on your individual risk level. Most people need blood tests every 3 to 6 months if they have conditions that can progress to AML. Early detection of blood count changes allows for prompt evaluation and treatment if needed.
Avoid crowds and people who are sick to reduce infection risk when your immune system is weak. Eat a balanced diet with enough protein to help your body recover from treatment. Stay hydrated and rest when you feel tired. Do not smoke, as tobacco damages your bone marrow and slows recovery. Gentle exercise like short walks can help maintain strength when your doctor says it is safe.
Yes, AML can return even after achieving remission. This is called relapse and happens when some leukemia cells survive treatment and begin growing again. Regular blood tests after treatment help detect relapse early when it is easier to treat. Many patients who relapse can achieve a second remission with additional chemotherapy or stem cell transplant.
Talk to your doctor right away if blood tests show abnormal results. Low platelets and neutrophil abnormalities have many possible causes besides leukemia. Your doctor will evaluate your symptoms, medical history, and complete blood count patterns. They may order additional tests or refer you to a blood specialist for further evaluation if needed.