What are the first signs of acute myeloid leukaemia?

AML affects the bone marrow, where blood cells are made. Reduced red blood cells can cause tiredness, weakness, dizziness or breathlessness. Fewer platelets can lead to easy bruising, nosebleeds, bleeding gums or tiny red-purple skin marks. A shortage of healthy infection-fighting cells can cause unexplained fever, chills, sore throat or infections that keep returning. Some people also notice pale skin, reduced appetite, night sweating, bone discomfort or fullness under the ribs. These symptoms can have other causes, including myelodysplastic syndromes or myeloproliferative neoplasms, so symptoms alone cannot confirm AML.

Arrange prompt medical review for persistent or worsening symptoms, especially unusual bruising, bleeding or fever. A clinician may examine you and request a complete blood count, blood film and other tests; if results are concerning, a haematology team may assess the bone marrow. Record when symptoms began, any infections, bleeding, medicines and family history. Do not stop prescribed medicines without advice.

Seek urgent help for a fever during a period of suspected low immunity, bleeding that will not stop, vomiting blood, black stools, severe breathlessness, chest pain, sudden weakness, confusion or a severe headache. These symptoms can need immediate treatment even before a diagnosis is confirmed.

Could a blood count explain these symptoms? Do I need urgent haematology review? What should I do if I develop fever or bleeding? Which tests would distinguish AML from another marrow disorder?