What is acute myeloid leukemia?
AML begins in the myeloid line of blood-forming cells and usually produces immature cells that do not function normally. Their rapid growth can suppress normal red cells, platelets, and infection-fighting white cells. AML is biologically diverse: some forms are defined by recurrent chromosome or gene changes, while others arise after prior blood disorders or cancer therapy. Acute promyelocytic leukemia is a distinct AML subtype with specific treatment and an important early bleeding risk. Most cases occur in adults, and incidence rises with age, but AML also affects children. Recognized risk factors include certain inherited conditions, tobacco exposure, substantial benzene or radiation exposure, prior chemotherapy, and myelodysplastic or myeloproliferative disorders; many patients have no identifiable cause. Care depends on the precise subtype, whether disease is untreated, in remission, refractory, or recurrent, cytogenetic and molecular biomarkers, measurable residual disease, age, organ function, and ability to tolerate intensive therapy.
Signs and symptoms
AML symptoms often develop over weeks as normal blood-cell production falls. Anemia may cause fatigue, weakness, pale skin, dizziness, or shortness of breath. Low functional white-cell counts can lead to fever or frequent and severe infections. Low platelets may cause easy bruising, nosebleeds, bleeding gums, prolonged bleeding, or pinpoint red or purple spots. Some people have bone or joint pain, reduced appetite, weight loss, night sweats, or abdominal fullness from an enlarged spleen or liver. Leukemia cells can occasionally form a mass outside marrow or affect the skin, gums, or nervous system. Acute promyelocytic leukemia can present with serious bleeding or abnormal clotting. These findings can also occur with infections, medication effects, vitamin deficiencies, immune disease, and other noncancer conditions. Fever, heavy bleeding, new confusion, or breathing difficulty needs urgent clinical assessment.
Diagnosis and staging
A complete blood count with differential and peripheral smear may show anemia, low platelets, abnormal white-cell counts, or blasts. Bone marrow aspiration and biopsy confirm AML and assess the proportion and appearance of abnormal cells. Flow cytometry identifies myeloid markers and helps distinguish AML from other leukemias. Cytogenetic analysis, fluorescence in situ hybridization, and broad molecular testing identify defining and risk-related changes, including alterations that can guide targeted treatment. Coagulation testing is urgent when acute promyelocytic leukemia is suspected. Blood chemistry evaluates organ function and tumor lysis risk; lumbar puncture or imaging is reserved for selected symptoms or subtypes. AML generally is not assigned a stage I–IV. Clinicians classify the subtype and describe disease as newly diagnosed, in remission, measurable residual disease positive or negative, refractory, or recurrent. Risk grouping combines genetics and response. Care planning depends on subtype, biomarkers, disease status, prior disorders or treatment, age, fitness, and organ function.
Established treatment paths
AML treatment is tailored to disease biology and the person’s ability to tolerate therapy. Fit patients often receive intensive remission-induction chemotherapy, commonly built around cytarabine and an anthracycline, followed by consolidation chemotherapy or allogeneic stem cell transplantation according to relapse risk and response. Older or less-fit adults may receive lower-intensity therapy such as a hypomethylating agent combined with venetoclax or another appropriate regimen. Targeted medicines may be added or substituted when AML carries actionable changes such as FLT3 or IDH1/2 alterations. Acute promyelocytic leukemia is treated differently, typically with all-trans retinoic acid and arsenic trioxide, with additional therapy based on risk. Recurrent or refractory AML may be treated with salvage chemotherapy, mutation-directed therapy, transplant, or a clinical trial. Central nervous system–directed therapy is used when indicated. The plan depends on subtype, cytogenetic and molecular biomarkers, measurable residual disease, prior therapy, age, comorbidities, organ function, and patient preferences. Treatment response is assessed with repeat blood, marrow, and sometimes molecular testing. Maintenance therapy is appropriate in selected settings, including some patients who cannot proceed to transplant.
Supportive care
AML and its treatment can cause profound low blood counts, so supportive care commonly includes red-cell and platelet transfusions plus antibacterial and antifungal prevention or treatment. Teams monitor for fever, bleeding, tumor lysis syndrome, electrolyte changes, and treatment-related organ effects; fever during neutropenia can be an emergency. Nausea control, mouth care, nutrition, pain management, activity support, and psychosocial care are also important. Fertility preservation may be considered before treatment when time and clinical stability allow. Palliative care can help manage symptoms and clarify goals alongside active leukemia therapy. Follow-up evaluates remission, measurable residual disease, recurrence, transplant complications, and late effects. All medicines, vaccines, herbs, and supplements should be reviewed for interactions and immune or bleeding risks.
Profiles documenting acute myeloid leukemia care
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Sources
Source information checked: 2026-09-29. The links below identify the public and clinic-provided materials used for this page.
- NCI: Acute Myeloid Leukemia Treatment ↗Checked 2026-09-29
- NCI: Leukemia—Patient Version ↗Checked 2026-09-29
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