Elsevier Patient Education © 2023 Elsevier Inc..

Last revised: February 22, 2023.

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Acute myelogenous leukemia (AML) is a cancer of the blood and the soft tissue inside the bones (bone marrow). AML happens when the bone marrow makes abnormal myeloid cells. Myeloid cells are immature blood cells that normally go on to develop into blood cells that help fight infection, carry oxygen, and stop bleeding. The abnormal myeloid cells, called leukemia cells, grow rapidly and take up space in the blood where healthy blood cells would normally be functioning. Leukemia cells lower your ability to fight infection and illness. This cancer can grow quickly.

There are several types of AML. The types vary depending on the characteristics of the leukemia cells and the abnormal changes (mutations) in the genes of the cells. Other types of AML vary depending on whether the leukemia is related to a therapy, blood disorder, or Down syndrome.

What are the causes?

The exact cause of AML is not known.

What increases the risk?

You are more likely to develop this condition if you:

  • Are 65 years of age or older.

  • Are male.

  • Smoke.

  • Have had past treatment with chemotherapy or radiation therapy.

  • Have been exposed to certain chemicals, such as benzene.

  • Have other blood disorders.

  • Have a genetic disorder, such as Down syndrome.

What are the signs or symptoms?

Symptoms of this condition include:

  • Weakness, tiring easily, or shortness of breath.

  • Fever.

  • Unusual bruising or pinpoint-shaped dark spots under the skin that are caused by bleeding (petechiae).

  • Nosebleeds or excessive bleeding from small cuts.

  • Repeat infections or slow healing of cuts.

  • Abdominal pain, an enlarged liver or spleen, or swollen lymph nodes.

  • Pale skin or a skin rash.

  • Headaches.

  • Pain or aches in the bones or joints.

  • Swollen gums.

  • Poor appetite or weight loss.

How is this diagnosed?

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This condition may be diagnosed based on:

  • Your symptoms and medical history.

  • A physical exam.

  • Tests, such as:

    • Blood tests to check blood cell counts and the shape of the blood cells.

    • Genetic tests to help determine the best way to treat the disease.

    • A bone marrow aspiration test to check for leukemia cells.

    • A lumbar puncture (also called a spinal tap) to check for leukemia cells in a sample of the fluid that surrounds the brain and spinal cord.

    • Testing a sample of tissue from a lump under the skin (biopsy).

    • Imaging tests, such as X-rays, ultrasound, or CT scans.

How is this treated?

Treatment for this condition depends on the type of AML. Treatment may last for several months and sometimes for up to 2–3 years. Treatment aims to destroy leukemia cells and stop new diseased cells from growing. Treatment for AML is usually treated in phases:

  • The first phase is called induction therapy. This therapy is used to destroy as many leukemia cells as possible.

  • The next stage is called consolidation therapy. This therapy is used to prevent cancer cells from coming back.

Treatments that may be done in these phases include:

  • Chemotherapy. This is the most common treatment and involves using medicines that kill cancer cells.

  • Targeted therapy. This is the use of medicines that treat specific gene mutations to stop the leukemia cells from growing and multiplying. They attack specific leukemia cells without harming normal cells.

  • High-dose chemotherapy followed by a stem cell transplant. A transplant replaces diseased bone marrow with healthy donor bone marrow.

  • Radiation therapy. This is the use of high-energy rays to kill cancer cells.

  • Participating in clinical trials to find out if new treatments are effective.

To help manage symptoms or side effects, you may also be given other treatments, such as:

  • Donated blood (transfusions).

  • Antibiotic medicines.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

  • Do not take dietary supplements or herbal medicines unless your health care provider tells you to take them. Some supplements can make treatment less effective.

If you are on chemotherapy:

  • You and any visitors should wash hands often for at least 20 seconds, especially before meals, after being outside, and after using the toilet.

  • Keep your teeth and gums clean and well cared for. Use soft toothbrushes.

  • Protect your skin from the sun by using sunscreen and wearing protective clothing.

  • Make sure that your family members get a flu shot (influenza vaccine) every year.

General instructions

  • Avoid crowded places and people who are sick.

  • Avoid contact sports and other rough activities. Ask your health care provider what activities are safe for you.

  • Work with your cancer care team to manage any side effects of treatment.

  • Try to eat healthy meals on a regular basis. Some treatments might affect your appetite.

    • Rinse all fruits and vegetables well.

  • Find healthy ways of coping with stress, such as by doing yoga or meditation or by joining a support group.

  • Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

Contact a health care provider if you:

  • Have a cough or cold symptoms.

  • Have a sore throat.

  • Have painful urination.

  • Have frequent diarrhea.

  • Cannot eat or drink without vomiting.

  • Have a skin rash.

  • Have blood in your urine or stool.

  • Have been exposed to chickenpox or measles, especially if you are not immune to these illnesses.

Get help right away if you:

  • Have a fever or chills.

  • Have trouble breathing.

  • Have blurry vision.

  • Feel confused.

Summary

  • Acute myelogenous leukemia (AML) is cancer of the blood and bone marrow. This cancer can grow quickly.

  • This condition is more likely to develop in older adults and in people who have other blood disorders, people who have received chemotherapy or radiation, people who have had exposure to certain chemicals, or those who have Down syndrome.

  • This condition is usually treated with chemotherapy. Treatment may continue for years.

  • Some people with this condition require a stem cell transplant.

  • Make sure you know the symptoms that should prompt you to call your health care provider or to go to the emergency room.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.