Diagnosis and tests

Symptoms of AML

The related article (“AML: symptoms and diagnosis”) explains platelets. This topic looks closely at the symptoms of acute myeloid leukaemia (AML): why they happen and which ones are urgent.

Last updated: ~1 min read
Three icons in a row.
Figure 1.Anaemia, bleeding, infection.

01Short answer

Most AML symptoms come from a fall in normal blood cells in the bone marrow. Too few red cells cause tiredness, paleness, breathlessness and a pounding heart; too few platelets cause easy bruising, nose and gum bleeds and tiny red spots on the skin (petechiae); too few working neutrophils cause repeated or severe infections and fever. Symptoms usually build up quickly over weeks. In some types of AML, leukaemia cells move into tissues, causing swollen gums or skin lumps. A very high white count can cause headache, vision problems or breathlessness (leukostasis), which is an emergency. These symptoms also occur in other illnesses; only tests can make the diagnosis.

02Simple explanation

Three shortages: anaemia, bleeding, infection.

Fast: over weeks.

Urgent: leukostasis, heavy bleeding.

03Scientific explanation

Extramedullary disease: gum infiltration and skin involvement are more common in monocytic types of AML.

Leukostasis: a very high blast count can block small vessels and affect the lungs and brain.

04What happens in the body?

Three shortages

Anaemia, low platelets and too few working neutrophils cause the main symptoms.

Gums

In some types of AML the gums can swell.

Swollen gums along the teeth.
Figure 2.Swollen gums — Symptoms of AML

A quick start

Symptoms can build up over a few weeks.

A short calendar strip.
Figure 3.A quick start over weeks.

05How symptoms arise

Four steps.

Marrow — Blasts multiply.1MarrowBlasts multiply.
Shortage — Normal cells fall.2ShortageNormal cells fall.
Symptoms — Tiredness, bleeding, infections.3SymptomsTiredness, bleeding, infections.
Seeking help — A blood test.4Seeking helpA blood test.

06Symptom and cause

SymptomCause
Tiredness, paleness, breathlessnessToo few red cells
Bruises, bleeding, petechiaeToo few platelets
Fever, infectionsToo few working neutrophils
Swollen gumsTissue infiltration
Headache, vision problemsLeukostasis (urgent)

07Key terms

Petechiae
Tiny red spots on the skin.
Anaemia
Too few red cells and too little haemoglobin.
Leukostasis
Blocked vessels from a very high white count.
Infiltration
Leukaemia cells moving into tissues.
Cytopenia
A shortage of blood cells.

08Key points

  • AML symptoms come from cell shortages.
  • They can build up fast.
  • Watch for bruising and bleeding.
  • Repeated infections are a signal.
  • Some symptoms are urgent.
  • Only tests make the diagnosis.

09Frequently asked questions

If I have these symptoms, is it definitely AML?

No; they usually have other causes. A blood test will clarify.

Is there pain?

Sometimes there is bone or joint pain.

When do I need emergency help?

With heavy bleeding, confusion, severe breathlessness or a high fever.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. If I have these symptoms, is it definitely AML?

  2. Is there pain?

  3. When do I need emergency help?

My questions

12Sources

  1. National Cancer Institute (NCI). Adult AML treatment (PDQ), patient version
  2. MedlinePlus. Blood smear
  3. American Cancer Society. Infections in People with Cancer
  4. American Cancer Society. Tests for CML
  5. Testing.com. Blood Smear Test: What It Shows and What Results Mean
  6. Cancer Research UK. Bone marrow test
  7. Testing.com. Bone Marrow Aspiration and Biopsy: What to Know
  8. Testing.com. Immunophenotyping by Flow Cytometry Explained
  9. Leukemia, 2012. EuroFlow antibody panels for standardized n-dimensional flow cytometric immunophenotyping of normal, reactive and malignant leukocytes
  10. Blood (American Society of Hematology), 2018. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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