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Acute Myeloid Leukemia: Symptoms and Signs

Posted on April 13, 2021
Medically reviewed by
Mark Levin, M.D.
Article written by
Maureen McNulty

Acute myeloid leukemia (AML) is a type of blood cancer that can cause many different symptoms and signs. AML grows and spreads at a fast pace, so it can begin causing symptoms soon after it develops. If you begin to experience symptoms that can be AML, it’s important to talk to your doctor as soon as you can.

Although the terms “symptoms” and “signs” are often used interchangeably, they have slightly different meanings. A disease symptom is an internal experience, such as a feeling of nausea or pain. A symptom can’t be directly felt or observed by another person. On the other hand, a disease sign is an external feature that can be seen or measured by a doctor. Examples of signs include fever or a rash. Many times, signs and symptoms are closely linked.

General Symptoms of Acute Myeloid Leukemia

The earliest symptoms of AML are often the same as those caused by other mild illnesses such as the flu. Symptoms can include:

Many of these symptoms first appear as things that only you can identify. For example, no one else can know for sure whether you feel more tired than usual. For this reason, it is important to bring these symptoms up to your doctor. Telling your doctor about your symptoms can help them know what other signs to look for.

Tests for AML

If you are experiencing AML symptoms, your doctor may use diagnostic tests to look for AML or other conditions and to explain why you are feeling that way. Many of these signs can be identified with blood tests, imaging tests, or a biopsy. During a biopsy, a small piece of tissue is removed and sent to a lab to be studied. Test results identify signs that tell you more about why you are feeling sick.

Low Levels of Normal Blood Cells

AML often leads to decreased numbers of healthy blood cells. This happens because leukemia cells multiply quickly, crowding out your body’s normal blood cells. When your body doesn’t have enough normal cells, you will probably experience specific symptoms. Low blood cell counts are a sign of AML that can be measured with a blood test called a complete blood count (CBC).

Red Blood Cells

Red blood cells deliver oxygen to organs and tissues throughout the body. When you have low red blood cell counts, it is called anemia. Anemia can cause the following symptoms:

  • Fatigue
  • Weakness or dizziness
  • Headaches
  • Uneven heart rhythms
  • Pale or yellowish skin
  • Chest pain or shortness of breath

White Blood Cells

People with AML also often have decreased numbers of white blood cells called neutrophils. These cells are a part of the immune system and help protect the body from bacteria and fungi. Low levels of neutrophils can lead to infection. Signs of infection can include:

  • Fever of at least 100.5 degrees Fahrenheit (38 degrees Celsius)
  • Chills or sweating
  • Belly pain
  • Painful urination
  • Mouth sores or a sore throat
  • Coughing
  • Redness and swelling in a particular area

Platelets

If you have AML, you may also have low levels of platelets, which are responsible for making your blood clot. Having low platelet numbers is called thrombocytopenia. When you don’t have enough platelets, you can have bleeding problems such as:

  • Bleeding for a long time from small cuts
  • Bruising
  • Bleeding gums
  • Nosebleeds
  • Petechiae (small red spots that appear on your skin)

High Levels of Leukemic Cells

Sometimes, large numbers of cancer cells in the blood can block blood vessels, preventing normal cells from getting through. This blockage can cause stroke-like symptoms, including weakness in one side of the body, confusion, headache, and slurred speech. This condition is rare, but if you experience these symptoms, seek immediate medical care.

AML Spreading Throughout the Body

AML begins in the bone marrow (the spongy tissue found inside certain bones). However, as cancer grows, leukemic cells can spread to other locations and build up in different organs. This buildup can lead to additional signs and symptoms, including:

  • Bone and joint pain
  • Belly pain or swelling
  • Skin rashes
  • Bleeding gums
  • Abdominal discomfort or pain
  • Seizures
  • Balance problems
  • Vision problems
  • Swollen lymph nodes, which appear as lumps in the neck, armpit, or groin

Other Health Concerns Related To AML

Many people with AML develop additional health problems after they are diagnosed and begin undergoing treatment. These problems may be related directly to the disease, or they may be caused by cancer treatments.

Treatment Side Effects

AML treatments have the potential to cause side effects. These side effects can make it harder to deal with treatment. For example:

  • Tiredness
  • Nausea
  • Vomiting
  • Diarrhea
  • Skin rashes
  • Mouth sores
  • Hair loss
  • Infections

Some side effects may be mild, whereas others can be severe and require medical attention. Contact your doctor if you develop a fever, unusual bleeding, severe nausea or vomiting, or new aches and pains. Additionally, ask your doctor about potentially serious side effects.

Some treatments may also cause long-term side effects that last after treatment ends. For example, certain medications may increase your risk of developing heart failure or additional cancers in the future. If you go into remission, ask your doctor what other complications you need to watch out for. It’s also good to know how often you need to have follow-up appointments to monitor your health.

Depression

About 15 percent to 25 percent of people with cancer develop depression. It is normal to feel upset, scared, confused, or sad when you are diagnosed with a disease like AML. However, depression is a disorder that goes beyond simply feeling sad. People with depression often experience:

  • Feeling hopeless
  • Feeling anxious and afraid
  • Feeling guilty
  • Decreased appetite
  • Having trouble getting enough sleep
  • Having trouble coping with the cancer diagnosis
  • Not enjoying the activities anymore
  • Decreased sex drive
  • Trouble focusing or thinking clearly

These depression symptoms may be caused by the mental and emotional toll of dealing with your diagnosis and managing treatments. However, depression can also be caused by physical factors, such as pain, medications, vitamin deficiencies, or hormone imbalances. Talk to your cancer care team if you are experiencing mental health symptoms. There may be underlying factors that you can address and treat.

Managing AML Symptoms, Signs, and Side Effects

Palliative care is a type of medicine that is specifically focused on treating the signs and symptoms of chronic illnesses like cancer. You can receive palliative care regardless of your AML stage or prognosis. A palliative care specialist may be able to help you figure out how to prevent or lessen symptoms. They can also provide emotional, practical, and spiritual support. Talk to your cancer care team if you would like to be connected with a palliative care provider.

Connect With Others Who Understand

Are you working to manage leukemia signs and symptoms? Are you wondering if anyone else with AML is experiencing similar side effects? Connecting with other people can help you know you are not alone.

MyLeukemiaTeam is a social network of more than 7,000 people living with leukemia, as well as their families and caregivers. Join the conversation by commenting below or by posting on MyLeukemiaTeam.

All updates must be accompanied by text or a picture.
Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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