AML Symptoms – Common symptoms of Acute Myeloid Leukemia

What is Acute Myeloid Leukemia?

Acute Myeloid Leukemia is a fast growing cancer of your body’s blood-forming tissues.  This includes the bone marrow, blood cells and lymphatic system.  The platelets that make up the white and red blood cells develop abnormal cells that then grow quickly as acute myeloid leukemia progresses.  Current research points to the causes of leukemia as a combination of genetic factors, viruses and exposure to chemicals.  Acute myeloid leukemia can also be referred to as acute myelogenous leukemia. They are the same disease and the treatment and symptoms of both will be the same.

According to Cancer.net, AML comprises 31% of all adult leukemia cases.  While AML can be diagnosed at any age, the average age of diagnosis is 68.  AML is also diagnosed more in men than women.

The 3 main forms of the cancer are:

1. Acute Leukemia which presents as a proliferation of white blood cells in bone marrow or lymph node tissue.

2. Chronic Myelogenous Leukemia which is sometimes known as granulocytic leukemia.

3. Chronic Lymphocytic Leukemia which is common in elderly patients.

What are the common signs and symptoms of AML?

Many symptoms of AML are common to other diseases that are not nearly as severe.  Any time you are experiencing concerning symptoms, you should consult a medical doctor for care and support.  Your health is important.  A blood test will be needed to confirm the existence of acute myeloid leukemia.  The final diagnosis is usually made after a bone marrow test and sometimes by a spinal tap, also known as a lumbar (lower spine) puncture (LP).

Keep in mind that symptoms of AML are acute, which means they have a sudden onset and quickly accelerate.  They are not chronic mild symptoms that have built slowly over time. Chronic symptoms could be an indicator of a different type of leukemia and will require a different treatment plan.

What Are the Most Common AML Symptoms in the Elderly?

In addition to all of the symptoms of AML that are most common (fever, fatigue, red spots on the skin, bleeding, lack of appetite, feeling cold and joint or bone pain), older adults with acute myeloid leukemia may also be especially prone to:

• night sweats
• weakness
• shortness of breath
• bruising easily
• paleness

The risk of developing acute myeloid leukemia increases with age. It’s most common in people over 75, so paying close attention to these symptoms of AML and investigating the underlying cause is very important for elderly patients.

AML is a Cancer of the Blood

While AML starts in a patient’s bone marrow, the spongy tissue inside your bones, it is actually a cancer of the blood and prevents the growth of healthy blood cells. Bone marrow contains stem cells, which develop into three types of blood cells in the body:

White blood cells – These cells are part of the immune system.  Their primary job is to defend the body from infection and disease.  There are 3 types of white blood cells – granulocytes, monocytes, and lymphocytes and each perform slightly different functions for the immune system.  The formation of white blood cells is called hematopoiesis and begins in the bone marrow from stem cells.  An increased white blood cell count (WBC) is the result of stress, this could include infections, cancer, inflammation, trauma, pregnancy or exercise. In severe infections, immature cells called blasts are present.  The presence of these blasts is typically examined in blood tests to diagnose acute myeloid leukemia.

Red blood cells – These blood cells are formed in the bone marrow and carry oxygen from the lungs to all parts of the body and carry carbon dioxide, a waste product, to the lungs so that it can be excreted.  A high or low red blood count (RBC) is usually one of the first signs of an underlying disease.  A low red blood count is a sign of anemia, leukemia, malnutrition and multiple myelomas.

Platelets –Platelets help form blood clots to stop bleeding and help wounds to heal properly.  When platelets are low, bruising and excessive bleeding can be the result.

The most common symptoms of Acute Myeloid Leukemia are: 

When first diagnosed with acute myeloid leukemia, a patient may feel like they have come down with the flu or that they are getting sick with infections more easily than normal.  Patients may describe conditions that are affecting their overall health and well-being.  This is because their cells, particularly those in the blood, are abnormal or not functioning properly. If you are experiencing these type of conditions, it is important that you seek treatment of not only the health conditions that you are experiencing, but also the potential underlying cause of those symptoms.  Ask your doctor for resources that will help care and provide support for both.

The most common symptoms of AML a patient experiences are:

• Fever – This is especially concerning if there is no underlying infection.
• Tiredness or a general feeling of being run-down.  This will sometimes present as having difficulty breathing or a lack of energy on a recurring basis.
• Lack of appetite or unexplained weight loss
• Feeling cold
• Bone/joint pain – This is referred to as ossalgia and is caused by the buildup of leukemia cells in the bones or joints.

As AML progresses additional symptoms may present in the patient and require treatment for both these symptoms and the underlying disease.  Many of these signs and symptoms of AML are actually the result of the disease progressing and the resulting shortage of normal red blood cells and white blood cells in the body.  The cancer causes changes in the bone marrow, where normal blood cells are crowded out or no longer produced.  The resulting shortages show up on blood tests or within the marrow of the bone.

• Abnormal blood counts – As AML progresses the count of red blood cells and white blood cells will decrease.
• Headaches – Headaches are associated with both high red blood cell counts and low white blood counts.  Symptoms of headaches may lessen as both of these underlying issues are addressed through treatment.
• Recurring or chronic infections – This can occur as a result of the shortage of normal white blood cells which are the infection fighting cells within the lymph system.  Although sometimes people with AML can have high white blood cell counts from leukemia, these white blood cells do not fight infection the way normal, healthy cells do.  Thus, the patient often has unexplained and recurring infections.
• Swollen lymph nodes – This occurs when the leukemia spreads to the lymph nodes.  This is a rare symptom of AML.
• Anemia and its related symptoms (lightheadedness, weakness, headache) – Anemia is a condition of the blood, where there are not enough healthy red blood cells to carry oxygen to the body’s cells and tissues.  Anemia can lead to a rapid or irregular heartbeat as the heart increases the rate at which it pumps blood to make up for the lack of oxygen in the blood.
• Abdominal inflammation or swelling – If the leukemia cells build up in the liver and spleen, the result can be inflammation or swelling in the abdominal area, which doctors can detect even though the area is covered by the lower ribs.
• Swelling, pain, bleeding of the gums – This is the result of low blood platelet counts.

• Excess bleeding, frequent nose bleeds.

• Rash (spottiness or bumps) on the skin – Tiny red spots, or petechiae, commonly form on the skin of people with leukemia.  These tiny red dots that are pinpoints of blood, can occur just about anywhere on the body.  Common locations for the petechiae are on the chest, trunk, legs, feet, neck, face, hands and arms.  

Risk factors for AML Disease

Doctors have identified several risk factors associated with AML disease.  Many of these factors are not something a patient can influence, however healthy living can help support overall health and cancer treatment in many conditions.

• Previous chemotherapy or radiation treatments – Exposure to high levels of radiation, whether through chemotherapy or other exposures, has been associated with a higher risk factor for developing cancer.
• Exposure chemicals like benzene – Benzene has been linked to several forms of cancer.  Benzene is an organic compound that is used in the production of various oils, rubber products, dyes and plastics.  Benzene is used in the manufacturing process of these products and can depress the functioning of the immune system.
• Family History – As with most diseases, if you have a family history of AML or leukemia related disorders, this increases your risk factors for developing AML.
• Genetic disorders like Down’s Syndrome
• Smoking – Smoking is associated with a higher risk of cancer including AML.
• Blood disorders like Myelodysplasia Syndromes – MDS are conditions where immature blood cells in the bone marrow become abnormal.  This results in the cells not becoming mature, or not developing into healthy blood cells.  The result is low numbers of either red or white blood cell counts.

Many patients with AML have no known risk factors, and many others who have risk factors do not develop AML.

Tests for AML

Since AML is a cancer that affects the immature stem cells that grow into red blood cells, white blood cells and platelets, there are several tests that can be used to diagnose AML and decide on a suitable treatment to bring AML into remission.  Your doctor should examine your overall health as part of the treatment plan that is developed. These tests are commonly used to help with the care of patients who suspect AML.

Blood tests

Blood tests are used to examine the complete blood count in a patient.  CBC consists of measurements for white blood cells, red blood cells and platelets.  When AML is present, a patient will have more white blood cells, and fewer red blood cells and platelets than normal.  Blood tests are one way in which doctors can screen for AML and decide on a course of treatment to correct the symptoms that are a result of the changes in healthy blood levels.

Bone Marrow Test 

Typically a bone marrow test will confirm the presence of acute myeloid leukemia in blood and / or bone cells.  Doctors take a small sample of bone marrow from the patient and examine the sample for the presence of immature blood cells or abnormal cancer cells.  If 20% or more of the blood cells are immature or abnormal, this may indicate the presence of cancer cells and the onset of acute myeloid leukemia.  This test can also help determine if someone is a good candidate for an allogeneic stem cell transplant.

Lumbar Puncture

A lumbar puncture or spinal tap is performed to take a sample of cerebrospinal fluid (CSF), the fluid surrounding the brain and spinal cord.  Doctors can then examine the fluid for the presence of cancer cells like acute myeloid leukemia.

Imaging Tests

Various imaging tests, such as CT, Ultrasound and X-rays, can be used to get a clear picture of what is happening inside the body.  While AML doesn’t form a tumor or other growth that will show up on a scan, a doctor may order imaging tests to help diagnose and decide on treatment for underlying infections or other symptoms that acute myeloid leukemia can cause.

Chromosome or Gene Tests

Gene changes can be indicative of certain types of acute myeloid leukemia.  Translocation, where two chromosomes switch DNA, can sometimes occur with AML.  Your doctors may request a cytogenetic analysis to look for these changes in the chromosomes of cells and decide on a cancer treatment plan.

Do AML Symptoms come on suddenly?

The acute portion of acute myeloid luekemia’s name is a description of the quick onset of the disease.  It is a fast growing cancer that needs immediate treatment.  Symptoms of AML can develop quickly over the course of a few days or weeks and are a result of the changes to the blood count.  AML interferes with the production of healthy blood cells, decreasing the body’s ability to grow immature blood cells into mature cells that form white blood, red blood and platelets.

In contrast, chronic leukemia (CLL) develops much more slowly over time and can take years to adversely affect the cells and manifest symptoms in a patient.  While many of the symptoms of chronic leukemia are similar to AML, they tend to be less severe and the cancer progresses at a much slower rate.  Symptoms common to both types of cancer are:

• Lumps in the Neck – These are usually the result of swelling of the lymph nodes as they fight off infection throughout the body’s cells.
• Pain or Swelling in the Belly – This is a result of swelling of the spleen and liver from leukemia.
• Fever, chills and night sweats – These symptoms are usually a result of changes in the overall blood count.
• Weakness and Fatigues – These symptoms are also a result of changes in the patient’s blood count.

Patient Resources for AML

The diagnosis and treatment of complicated cancers like leukemia require the support, care and resources of many involved in the patient’s care.

The Sierra Clinical Trial is working to ensure the best care for those suffering from AML symptoms.  The trial is examining the effectiveness of the investigational drug Iomab-B, which may enable more transplants in patients age 55 and older. 

These Additional AML Resources may be of use as you care for the health of a patient or loved one with AML and the symptoms of acute myeloid leukemia.

Learn The Basics of BMT – A Bone Marrow Transplant with the help of the investigational medicine, Iomab-B, may present a course of cancer treatment for patients over the age of 55 with AML Symptoms.  

Support For You and Your Family – Caring for a loved one undergoing treatment for AML is difficult.  These resources can help you care for the health of your loved one and support them on their journey with Acute Myeloid Leukemia symptoms and treatment.

Find A Clinical Trial  Interested in learning more about the clinical trials currently underway for the treatment of AML cancer?  Learn more and see if a clinic near you is offering an acute myeloid leukemia clinical trial.

What Is A Blood Stem Cell Transplant? Need help understanding what a stem cell transplant involves and how it can help alleviate the symptoms of AML.  This resource helps explain how stem cells and a bone marrow transplant can be pivotal in treating AML and the symptoms of the disease. 

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