What is AML?
What is AML?Acute myeloid leukemia (AML) is a type of fast-growing cancer that starts in the bone marrow, which is the soft tissue inside your bones where blood cells are made. In AML, the bone marrow produces abnormal, immature white blood cells (called myeloblasts or “blasts”) that do not function properly.
As these cells multiply, they begin to crowd out healthy blood cells and disrupt normal blood production. This can affect your body’s ability to carry oxygen, fight infection, and control bleeding.
These abnormal cells:
- Grow quickly (which is why AML is called “acute”)
- Crowd out healthy blood cells
- Can enter the bloodstream and, in some cases, spread to other parts of the body
How does AML differ from other leukemias?
Leukemia is a group of blood cancers rather than a single disease, and each type behaves and is treated differently. AML is one of several types of leukemia. It is defined by how quickly it progresses and the type of cells (myeloid) it affects. Other major leukemia types include acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML).
Acute myeloid leukemia symptoms & risk factors
Symptoms and risk factorsThe signs of AML can develop quickly and may be easy to overlook at first. Some symptoms may feel like common illnesses, such as the flu or fatigue, which can delay diagnosis. Understanding common symptoms and potential risk factors can help you recognize when to seek evaluation by an AML specialist.
What are the common symptoms of acute myeloid leukemia?
Since AML interferes with the production of healthy blood cells, many symptoms are associated with low levels of normal blood cells:
Low red blood cells (anemia):
- Fatigue or weakness
- Shortness of breath
- Pale skin
Low white blood cells:
- Frequent infections
- Fever
- Mouth sores
Low platelets:
- Easy bruising
- Bleeding (nosebleeds, bleeding gums)
- Small red or purple spots on the skin (petechiae)
Other possible symptoms:
- Bone or joint pain
- Unexplained weight loss
- Loss of appetite
- Swollen gums (in some subtypes)
If these symptoms persist or worsen, it’s important to speak with a doctor. While they may be caused by conditions other than AML, they should be evaluated.
Risk factors for AML
AML can develop in individuals without any clear risk factors. However, certain factors are known to increase risk:
- Age (more common in adults older than age 60)
- Prior chemotherapy or radiation therapy
- Exposure to certain chemicals (e.g., benzene)
- Smoking
- Certain blood disorders (like myelodysplastic syndromes)
- Genetic conditions (such as Down syndrome)
Not everyone with AML has identifiable risk factors, and having a risk factor does not mean you will develop the disease. These factors are considered alongside your symptoms and medical history during evaluation.
How is AML diagnosed?
How is AML diagnosedAn AML diagnosis involves a series of tests to examine your blood and bone marrow. At NewYork-Presbyterian, the goal is to reach an accurate diagnosis efficiently so treatment can begin without delay.
Initial testing
- Initial testing for AML may include:
- Blood tests: Check for abnormal cell levels and the presence of immature cells (blasts)
- Physical exam: Evaluates symptoms such as bruising, infection, or fatigue
Bone marrow evaluation
A bone marrow biopsy is needed to confirm an AML diagnosis. During this procedure, a small sample of bone marrow is collected, usually from the hip, and examined to:
- Measure how many leukemia cells are present
- Identify the specific type (subtype) of AML
This procedure is typically done with local anesthesia and is an important step in getting an accurate diagnosis.
Advanced diagnostic testing
NewYork-Presbyterian uses specialized testing to better understand your leukemia and guide personalized AML treatment, including:
- Cytogenetic testing: Looks at chromosome changes
- Molecular testing: Identifies gene mutations (e.g., FLT3, NPM1) + next generation sequencing (NGS)
- Flow cytometry: Classifies leukemia cell type
These results determine your risk stratification to help us decide how aggressive your treatment needs to be.
AML treatment options
Treatment options (high level)A diagnosis can feel overwhelming, but you don’t have to navigate it alone. At NewYork-Presbyterian, you’ll benefit from experienced AML specialists who provide a full range of treatment options, from chemotherapy to stem cell transplantation and clinical trials. We work closely with you to develop a personalized treatment plan based on your specific diagnosis, overall health, and goals.
Your care team will consider factors like age, overall health, genetic findings, and disease characteristics. For many patients, treatment happens in phases and may include a combination of therapies. Your care team will explain each phase so you know what to expect along the way.
Goals of AML treatment
- Eliminate leukemia cells (remission)
- Prevent relapse
- Restore normal blood cell production
Common AML treatment approaches
1. Chemotherapy
Chemotherapy is often the first step in AML treatment. It is typically given in a hospital or specialized outpatient setting, where patients can be closely monitored for side effects and response to treatment.
- Induction therapy: Intensive treatment delivered in a hospital setting to eliminate as many leukemia cells as possible and achieve remission
- Consolidation therapy: Follow-up treatment to kill any "hidden" leukemia cells and prevent the cancer from returning
2. Targeted therapy and immunotherapy
For patients with specific genetic mutations, we use "smart" drugs that attack the cancer without harming as many healthy cells:
- Targeted inhibitors: Drugs that block the effects of mutations like FLT3 or IDH1/IDH2, and, more recently, NPM1 (menin inhibitors)
- Monoclonal antibodies: Immunotherapies that help your immune system recognize and destroy AML cells
3. Lower-Intensity therapies
For older adults or those with other health concerns, we offer effective, lower-intensity options, such as hypomethylating agents, designed to manage the disease while prioritizing quality of life.
Stem cell transplant and cellular therapies
Stem cell transplant and cellular therapiesFor many patients, especially those at higher risk of relapse, a stem cell transplant may offer the best chance for long-term remission. This approach is often considered after initial treatment has reduced the amount of leukemia in the body.
What is a stem cell transplant?
A stem cell transplant replaces diseased bone marrow with healthy stem cells from a donor. This process involves high-dose therapy followed by infusion of healthy stem cells to rebuild the bone marrow. NewYork-Presbyterian performs more than 200 stem cell transplants annually, specializing in high-risk cases.
Our specialized transplant units feature unique airflow systems and continuous monitoring to protect patients with weakened immune systems during recovery.
Clinical trials
Clinical trialsNewYork-Presbyterian is at the forefront of blood cancer research. Patients have access to leukemia clinical trials that offer investigational therapies before they are available elsewhere.
Participation is voluntary, and our team will walk you through every potential benefit and risk. Current research focuses on:
- New targeted drug combinations
- Innovative ways to make stem cell transplants safer and more effective
- Vaccine therapies for leukemia prevention
Supportive care during AML treatment
AML treatment affects more than just your blood cells. Our supportive care services are integrated into your treatment plan from day one to support your physical and emotional well-being:
- Nutritional counseling: Helping you maintain strength during chemotherapy
- Pain and symptom management: Specialized palliative care to manage side effects
- Psychosocial support: Counseling and support groups for you and your family
- Spiritual support: Pastoral care offerings through our department of Spiritual Care and Chaplaincy
Why Choose NewYork-Presbyterian for AML treatment
Patients choose NewYork-Presbyterian because we combine the academic expertise of Columbia Irving Medical Center and Weill Cornell Medicine with a compassionate, patient-centered approach. We offer:
- Access to leading experts: World-renowned AML specialists coordinating every step of your care
- Advanced diagnostics: In-house genetic sequencing for faster, more accurate results
- Coordinated care: A multidisciplinary team that treats the whole person, not just the disease
This content has been reviewed by the following medical editors.