Acute Myeloid Leukemia Symptoms

April 19, 2024 
This page was reviewed under our medical and editorial policy by Guido Marcucci, M.D., Chair, Department of Hematologic Malignancies Translational Science, City of Hope Duarte

Not every person who develops acute myeloid leukemia (AML) experiences telltale symptoms that would indicate leukemia. Many symptoms of AML are also associated with common illnesses such as flu. Sometimes, patients don’t notice any symptoms, and the cancer is detected during routine blood tests.

AML Symptoms

Some people with acute myeloid leukemia experience general symptoms that don’t point to cancer on their own because they are vague and common to other conditions. These symptoms may include:

• Loss of appetite
• Weight loss
• Night sweats
• Fatigue
• Fever

Other AML symptoms may be due to the shortage of normal blood cells and which blood cells — white, red or platelets — are affected.

Red blood cells supply oxygen to cells. When they are in short supply, it is called anemia. AML symptoms related to low red blood cell counts may include:

• Lightheadedness
• Fatigue
• Headaches
• Feeling weak
• Dizziness
• Feeling cold
• Paleness
• Trouble breathing

The body depends on white blood cells called neutrophils to fight infection. When these normal white cells are in short supply, the risk of infection grows. People with AML may have extremely high white cell counts, but these cells don’t provide the protection that mature, healthy white blood cells do.

Symptoms related to white blood cell issues may include:

• Infections that tend to last for extended periods
• Infections that continue to recur
• Fever

Platelets help stop or prevent bleeding. Symptoms from low blood platelet counts with AML may include:

• Bruising and bleeding easily
• Tiny red spots under the skin (petechiae)
• Swollen or bleeding gums
• Heavier-than-normal menstrual periods in women
• Nosebleeds

Cancer cells in AML are called blasts. Bigger than normal white blood cells, they may get stuck in small blood vessels. When the blast count is too high, normal red blood cells are unable to deliver oxygen to tissues. Called leukostasis, this is a medical emergency.

Leukostasis symptoms may include:

• Slurred speech
• Headache
• Confusion
• Weakness on one side of the body
• Sleepiness
• Trouble breathing
• Blurry vision or loss of vision

Acute Promyelocytic Leukemia (APL) Symptoms

Acute promyelocytic leukemia (APL) is a type of AML that may cause problems with bleeding and blood clotting.

APL symptoms may include:

• Nosebleeds that don’t stop
• Bruises
• Tiny red spots under the skin (petechiae)
• Swollen or bleeding gums
• Heavier-than-normal menstrual periods in women
• Cuts that continue to bleed
• Deep vein thrombosis (DVT) or a blood clot in the calf
• Chest pain
• Shortness of breath from a blood clot in the lung (pulmonary embolism)

If leukemia cells build up near bones or inside joints, pain may occur.

If leukemia cells build up in the liver and spleen, these organs may become enlarged and cause the abdomen to swell.

AML Signs

AML symptoms are different from AML signs. A symptom is something that a person experiences. In contrast, a sign is something that a doctor spots.

Signs that may lead a doctor to suspect AML include:

• Unusual bloodwork (such as too many immature white cells and not enough red blood cells or platelets)
• A history of bleeding
• Unusual bruising
• An enlarged liver or spleen, which may be palpable during an exam
• Swollen lymph nodes
• Tiny red spots under the skin (petechiae)
• Deep vein thrombosis (DVT)
• Pulmonary embolism