Acute Myeloid Leukemia (AML)

Symptoms and Causes

What are acute myeloid leukemia symptoms?

Early on, AML symptoms may feel like you have a cold or flu that won’t go away. Acute myeloid leukemia is aggressive. That means you quickly develop new and more noticeable symptoms. Later symptoms include:

• Dizziness.
• Easy bruising or bleeding, including frequent nosebleeds and bleeding gums.
• Fatigue.
• Feeling cold.
• Fever.
• Night sweats.
• Frequent infections or infections that don’t go away.
• Headaches.
• Loss of appetite.
• Unexplained weight loss.
• Pale skin.
• Shortness of breath (dyspnea).
• Swollen lymph nodes.
• Weakness.
• Bone, back or abdominal pain.
• Tiny red spots on your skin (petechiae).
• Wounds or sores that don’t go away.

What causes acute myeloid leukemia?

Experts aren’t sure what causes acute myeloid leukemia. They do know the condition happens when certain genes or chromosomes mutate (change), creating abnormal blood cells. These genetic changes may happen:

• During your lifetime when something changes your DNA.
• If you inherited a genetic disorder that increases your risk of developing AML.
• If there was a change in certain genes in your biological parents’ sperm or egg.

How do genetic changes cause acute myeloid leukemia?

To understand how genetic changes cause AML, it may help to know more about your bone marrow and blood cells. Your bone marrow is soft, spongy tissue in the center of most of your bones. It makes:

• Stem cells (immature cells) that mature into red blood cells that carry oxygen.
• White blood cells that protect against infection.
• Platelets, which help your blood to clot.

Normally your bone marrow works like an efficient production line, consistently making the exact number of blood cells and platelets that your body needs to function. In AML, however, your bone marrow produces abnormal myeloid cells called myeloid blasts or myeloblasts.

Myeloid blasts don’t act like normal blood cells. Normal cells follow genetic directions that tell them when and how quickly they should multiply and grow. As cells get older, they die to make room in your bone marrow for new cells. Myeloid blasts don’t follow directions. They multiply uncontrollably and they don’t die. The continuous flow of myeloid blasts in your bone marrow means less room for healthy blood cells. Since there’s no room, your bone marrow stops making blood cells. Without new healthy blood cells, your body doesn’t have what it needs to function.

Moreover, as the myeloid blasts keep on multiplying, they begin to spill out of your bone marrow into your bloodstream. Once in your bloodstream, the myeloid cells travel to other parts of your body, including your central nervous system, brain and spinal cord.

What are the risk factors for acute myeloid leukemia?

While experts don’t know exactly what triggers the genetic mutations that cause AML, they do know about risk factors that increase your chance of developing the disease. (When you think about risk factors, it’s important to remember risk factors don’t mean you’ll get sick.) Acute myeloid leukemia risk factors include:

• Age. About half of all people with AML are 65 or older when they’re diagnosed. Again, AML typically affects adults but it can affect children.
• Smoking, including exposure to secondhand smoke.
• Cancer treatments, including chemotherapy and radiation therapy.
• Long-term exposure to chemical carcinogens such as benzene and formaldehyde.
• High-dose radiation exposure from a nuclear reactor accident or atomic bomb.
• Certain inherited (genetic) disorders.
• Other bone marrow disorders.

What genetic disorders increase the risk of developing AML?

Researchers know some inherited genetic mutations increase people’s risk for developing AML, including:

• Down syndrome.
• Ataxia telangiectasia.
• Li-Fraumeni syndrome.
• Klinefelter syndrome.
• Fanconi anemia.
• Wiskott-Aldrich syndrome, which affects platelet production.
• Bloom syndrome.
• Familial Platelet Disorder syndrome, which affects platelet disorder.

What bone marrow diseases increase the risk of developing AML?

Some people who have myeloproliferative neoplasms (myeloproliferative disorders) may develop acute myeloid leukemia. (Myelo means bone marrow. Proliferative means too many.) People with the following disorders may also develop ML:

• Polycythemia vera.
• Myelofibrosis.
• Thrombocytosis.
• Myelodysplastic syndrome.
• Aplastic anemia.

What are the complications of acute myeloid leukemia?

Early on, acute myeloid leukemia affects the number of healthy red and white blood cells and platelets that you have. If you don’t have enough healthy blood cells and platelets, you may develop the following conditions:

• Anemia.
• Thrombocytopenia.
• Pancytopenia (low blood cell and platelet levels).