What is acute myeloid leukemia (AML)?

Acute myeloid leukemia (AML) is a cancer of the blood-forming cells in the bone marrow. Bone marrow is the soft, spongy tissue inside your bones where blood cells are made. Your marrow normally makes three kinds of blood cells. White blood cells fight infection. Red blood cells carry oxygen. Platelets help your blood clot. In AML, young cells called blasts grow out of control and do not mature. They crowd out healthy cells, so counts of normal blood cells drop.

When should I call my care team?

Fever of 100.4 F (38 C) or higher, or shaking chills, even if you feel okay otherwise; Chills or shivering after your central line or port is flushed; Bleeding that will not stop, blood in your urine or stool, black stools, or vomiting blood; Sudden severe headache, confusion, vision changes, or weakness on one side (possible bleeding in the brain); Shortness of breath, chest pain, or a cough that is getting worse; Fast weight gain, new swelling, fever, or trouble breathing while on ATRA, arsenic, or an IDH or menin inhibitor (possible differentiation syndrome); Fainting, a racing or pounding heartbeat, or feeling like you might pass out; Passing much less urine than usual, or dark urine; Diarrhea that will not stop, or not being able to keep fluids down; After a donor transplant: a new rash, diarrhea, or yellow skin or eyes.

Acute myeloid leukemia (AML)

AML is a fast-growing blood cancer that needs care right away, and today there are more treatment choices than ever, including options for older adults.

Hi, I'm Rosa. Today we'll go through acute myeloid leukemia, or AML, together, one step at a time. I'll keep it simple, and you can pause me, go back, or skip ahead whenever you like. Just so you know, this is for learning only. It is not medical advice, so please check everything with your own doctor and care team. Okay, let's get started.

What AML is

Let's start with the basics. AML is a blood cancer. It starts in the bone marrow. That is the soft, spongy inside of your bones, where blood cells are made. In AML, young cells called blasts grow out of control. They do not grow up into healthy cells. They crowd out the good cells. So you may feel tired, get infections, or bruise and bleed easily. AML grows fast. That is why treatment often starts within days. Some people are cured. Your care team will explain the goal of treatment for you.

The main types

Let's talk briefly about the types. Today, many types of AML are named for a gene change in the leukemia cells. That name tells your team a lot. One special type is called APL. It can cause serious bleeding at the start, so it is an emergency. But it is one of the most curable leukemias. It is treated with a vitamin A-like pill and a medicine called arsenic. Some AML grows out of an earlier marrow problem. Some comes after past cancer treatment. Your care team will tell you which type you have.

Tests you may have

Now let's talk about tests. A blood count is often the first clue. A bone marrow biopsy confirms the diagnosis. A needle takes a small sample from the back of your hip. You get numbing medicine first. Lab tests look at markers on the cells. Gene tests look for changes inside the leukemia cells. Some of these come back in just a few days. You will have tests of how well your blood clots. A heart ultrasound may come before some medicines. A simple blood or cheek swab test can start the search for a donor.

Risk groups and phases

Next up, risk groups. AML does not have stages like many other cancers. That is because it is already in the blood and marrow. Instead, doctors sort AML into risk groups. These are favorable, intermediate, and adverse. They are based mostly on gene changes. Risk groups help your team decide if a stem cell transplant makes sense. Treatment also comes in phases. First comes induction, to reach remission. Remission means the marrow looks healthy again. Then comes more treatment to keep the leukemia away.

Gene tests to know

Before we move to treatment, there are some things to know. AML cells have gene changes. Testing for them is a key part of your care. Each change has a short name made of letters and numbers. Some changes point to a targeted pill made for that exact change. Some changes mean the leukemia may be easier or harder to treat. Your team may wait a few days for results before starting, if it is safe. Your doctor will tell you which changes you have and what they mean. The Questions to ask page can help you prepare.

Main treatments

Now let's talk about treatment. If you are strong enough, you may get intensive chemotherapy in the hospital. You usually stay about four weeks. A targeted pill may be added. If intensive chemotherapy is not safe for you, there is a gentler choice. It pairs a shot or IV called azacitidine with a daily pill called venetoclax. Many people also get a stem cell transplant from a donor. It gives many people the best chance of cure. Some people take maintenance pills afterward. Clinical trials are research studies that may offer new options. Ask your team about them.

Side effects and help

Let's look at side effects. Your white cells will get very low. That makes infections more likely. A fever is an emergency, so call right away. Many people need blood and platelet transfusions. Low platelets can cause bruising and bleeding. Use a soft toothbrush. Chemotherapy can cause nausea, mouth sores, and hair loss. Medicine and gentle mouth care help. Some AML drugs can cause fever, swelling, and trouble breathing. This can be treated if caught early. Feeling very tired is common. We have a whole side effects guide on this site.

Living with and after AML

Now let's talk about life during and after treatment. The first weeks are often the hardest. It helps to have a caregiver and to accept help. After treatment, you will have regular blood tests. These check that the leukemia has not come back. After a donor transplant, recovery can take a year or more. You will need your childhood vaccines again. Feelings matter too. Support groups and counselors can help you and your family. Call your care team right away for a fever or bleeding. If it feels very bad, call 911. Also visit our Screening, prevention and survivorship section.

You did great today. That was a lot, and you took it one step at a time. Write down your questions and bring them to your next visit. Call your care team any time something worries you, day or night. You are not alone in this.

Call your care team right away if you have

Fever of 100.4 F (38 C) or higher, or shaking chills, even if you feel okay otherwise
Chills or shivering after your central line or port is flushed
Bleeding that will not stop, blood in your urine or stool, black stools, or vomiting blood
Sudden severe headache, confusion, vision changes, or weakness on one side (possible bleeding in the brain)
Shortness of breath, chest pain, or a cough that is getting worse
Fast weight gain, new swelling, fever, or trouble breathing while on ATRA, arsenic, or an IDH or menin inhibitor (possible differentiation syndrome)
Fainting, a racing or pounding heartbeat, or feeling like you might pass out
Passing much less urine than usual, or dark urine
Diarrhea that will not stop, or not being able to keep fluids down
After a donor transplant: a new rash, diarrhea, or yellow skin or eyes

Side effects: what helps

Sources

Quick answers

What is acute myeloid leukemia (AML)?: Acute myeloid leukemia (AML) is a cancer of the blood-forming cells in the bone marrow. Bone marrow is the soft, spongy tissue inside your bones where blood cells are made. Your marrow normally makes three kinds of blood cells. White blood cells fight infection. Red blood cells carry oxygen. Platelets help your blood clot. In AML, young cells called blasts grow out of control and do not mature. They crowd out healthy cells, so counts of normal blood cells drop.
When should I call my care team?: Fever of 100.4 F (38 C) or higher, or shaking chills, even if you feel okay otherwise; Chills or shivering after your central line or port is flushed; Bleeding that will not stop, blood in your urine or stool, black stools, or vomiting blood; Sudden severe headache, confusion, vision changes, or weakness on one side (possible bleeding in the brain); Shortness of breath, chest pain, or a cough that is getting worse; Fast weight gain, new swelling, fever, or trouble breathing while on ATRA, arsenic, or an IDH or menin inhibitor (possible differentiation syndrome); Fainting, a racing or pounding heartbeat, or feeling like you might pass out; Passing much less urine than usual, or dark urine; Diarrhea that will not stop, or not being able to keep fluids down; After a donor transplant: a new rash, diarrhea, or yellow skin or eyes.

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.