Acute Myeloid Leukaemia (AML)

Acute myeloid leukaemia is a fast-growing blood cancer that requires prompt specialist assessment and treatment planning.

AML begins when immature myeloid cells in the bone marrow grow abnormally. These cells can crowd out healthy cells that normally become red blood cells, infection-fighting white blood cells and platelets. The effects can therefore involve oxygen delivery, infection control and normal clotting.

People with AML often develop tiredness, breathlessness, pale skin, repeated infections, fever, easy bruising or bleeding. Symptoms may appear over days or weeks. These changes can have many other causes, but a clinician should assess persistent or worsening symptoms promptly.

Seek urgent medical help for bleeding that will not stop, severe breathlessness, confusion, collapse or a high fever with marked illness. During treatment, use the oncology team's emergency number for fever, chills or sudden deterioration because infection can become serious quickly.

AML develops after acquired changes in the genetic instructions of a developing blood cell disrupt normal maturation and growth. The abnormal cells multiply and remain immature. In most people, there is no single action or event that explains why these changes occurred, and AML is not contagious.

Some cases arise after a previous bone marrow disorder, including myelodysplastic syndromes or myeloproliferative neoplasms. Others can follow earlier cancer treatment, while many develop without a clearly identifiable trigger.

Because leukaemia cells can increase rapidly in marrow and blood, assessment and treatment decisions usually move quickly. Doctors describe the disease using its cell appearance, chromosome findings and gene changes rather than a solid-tumour stage. These features help estimate how the AML may behave and guide therapy.

Risk can be higher with increasing age, tobacco exposure, substantial exposure to certain industrial chemicals, previous chemotherapy or radiotherapy, and particular marrow or inherited conditions. Having a risk factor does not mean a person will develop AML, and many diagnosed people have no obvious risk factor.

A full blood count and blood film can reveal abnormal cells and changes in healthy cell numbers. Confirmation generally requires a bone marrow aspiration and biopsy. Laboratory specialists examine the cells and test their chromosomes, proteins and genes. Results distinguish AML from other blood disorders and help match treatment to the disease biology.

Additional blood tests assess kidney, liver and clotting function. The team may also check the heart, infection status and tissue type before particular treatments. Testing is organised promptly, but the exact sequence depends on how unwell the person is.

Treatment is tailored to AML subtype, gene findings, general health, previous therapy and personal priorities. Chemotherapy may be used to bring the leukaemia into remission and then reduce remaining disease. Targeted medicines may be suitable when the cells carry a relevant feature. Some people are offered an allogeneic stem cell transplant when its potential benefit outweighs its risks.

Supportive care is part of active treatment. It can include red-cell or platelet transfusions, antibiotics, medicines for nausea and measures to prevent tumour lysis complications. The team may repeat marrow tests to assess response and adjust the plan.

Treatment can involve hospital stays and periods when infection risk is increased. Follow the team's advice on food hygiene, mouth care, medicines and contact with people who are unwell. Report fever, new bleeding, breathlessness or rapidly worsening fatigue through the agreed urgent-care route. Follow-up blood and marrow tests look for recovery and signs of persistent or returning disease.