Signs and symptoms of acute myeloid leukemia
Acute myeloid leukemia (AML) can cause many different signs and symptoms. Some occur more commonly with certain subtypes.
Patients with AML often have several non-specific (generalized) symptoms. These can include weight loss, fatigue, fever, night sweats, and loss of appetite. Of course, these are not just symptoms of AML, and more often are caused by something other than leukemia.
Problems caused by low numbers of blood cells
Most signs and symptoms of AML result from a shortage of normal blood cells, which happens when the leukemia cells crowd out the normal blood-making cells in the bone marrow. As a result, people do not have enough normal red blood cells, white blood cells, and blood platelets. These shortages show up on blood tests, and they can also cause symptoms.
Low red blood cell counts (anemia) can cause:
- Tiredness (fatigue)
- Feeling cold
- Feeling dizzy or lightheaded
- Shortness of breath
Infections can occur because of a shortage of normal white blood cells (a condition called leukopenia) or a shortage of normal neutrophils (called neutropenia). Neutrophils are a type of white blood cell needed to fight infections from bacteria. Patients with AML can get infections that don’t seem to go away or may get one infection after another. Fever often goes along with the infection.
Although people with AML may have high white blood cell counts due to excess numbers of leukemia cells, these cells do not protect them against infection the way normal white blood cells do..
A shortage of blood platelets (thrombocytopenia) can lead to:
- Excess bruising and bleeding
- Frequent or severe nosebleeds
- Bleeding gums
Symptoms caused by high numbers of leukemia cells
The cancer cells in AML (blasts) are bigger than normal white blood cells and have more trouble going through tiny blood vessels. If the blast count gets very high, these cells clog up blood vessels and make it hard for normal red blood cells (and oxygen) to get to tissues. This is called leukostasis. Leukostasis is rare, but it is a medical emergency that needs to be treated right away. Some of the symptoms are like those seen with a stroke, and include:
- Weakness in one side of the body
- Slurred speech
When blood vessels in the lung are affected, patients have problems with shortness of breath. Blood vessels in the eye can be affected as well, leading to blurry vision or even loss of vision..
Bleeding and clotting problems
Patients with a certain type of AML called acute promyelocytic leukemia (APL) might go to the doctor with problems with bleeding and clotting. They may have a nose bleed that won’t stop, or a cut that won’t stop oozing. They may also have calf swelling from a blood clot called a deep venous thrombosis (DVT) or chest pain and shortness of breath from a blood clot in the lung (called a pulmonary embolism or PE).
Bone or joint pain
Some patients have bone pain or joint pain caused by the buildup of leukemia cells in these areas.
Swelling in the abdomen
Leukemia cells may collect in the liver and spleen, causing them to enlarge. This may be noticed as a fullness or swelling of the belly. The lower ribs usually cover these organs, but when they are enlarged the doctor can feel them.
Spread to the skin
If leukemia cells spread to the skin, they can cause lumps or spots that may look like common rashes. A tumor-like collection of AML cells under the skin or other parts of the body is called a chloroma, granulocytic sarcoma, or myeloid sarcoma. Rarely, AML can present with only a chloroma and no leukemia cells in the bone marrow.
Spread to the gums
Certain types of AML may spread to the gums, causing swelling, pain, and bleeding.
Spread to other organs
Sometimes, leukemia cells may spread to other organs. Spread to central nervous system (brain and spinal cord) can cause headaches, weakness, seizures, vomiting, trouble with balance, facial numbness, or blurred vision. On rare occasions AML may spread to the eyes, testicles, kidneys, or other organs.
Enlarged lymph nodes
In rare cases, AML may spread to lymph nodes. Affected nodes in the neck, groin, underarm areas, or above the collarbone may be felt as lumps under the skin.
Although any of these symptoms and signs above may be caused by AML, they can also be caused by other conditions. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.
Last Medical Review: 07/24/2013
Last Revised: 02/07/2014