Hematologist
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AML explained: what happens and how fast | CION Cancer Clinics
Acute myeloid leukaemia (AML) is a blood cancer that starts in the bone marrow and usually develops over days to weeks. Young cells called blasts stop maturing, multiply and crowd out the red cells, white cells and platelets you need. That is why it causes tiredness, infections and bleeding, and why it needs a haematologist quickly. This page explains what AML is, how it is diagnosed and what it cannot tell you. At CION Cancer Clinics, every leukaemia, MDS and MPN case is reviewed by our haematologist and discussed at a tumour board before a plan is agreed.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What is AML, in plain words?
- What happens to the body when blasts crowd the marrow?
- How does a doctor go from a blood test to a diagnosis?
- Which words will you see on an AML report?
- What do families often believe about AML, and what is true?
- How is AML treated, and what can this page not tell you?
- Common questions about AML
The short answer
What is AML, in plain words?
Acute myeloid leukaemia (AML) is a blood cancer that starts in the bone marrow, the soft tissue inside your bones where blood is made. It usually develops over days to weeks, not years, so it needs a haematologist's attention quickly once it is suspected.
What goes wrong inside the marrow
Healthy marrow makes young cells that grow up into red cells, white cells and platelets. In AML, one young cell picks up changes in its genes. It stops growing up and starts copying itself. These stuck young cells are called blasts. They fill the marrow and push out the normal cells that keep you well.
Why "acute" matters
Acute describes speed. The blasts build up fast, and the drop in normal blood cells follows. Many people feel well one month and quite unwell the next. That is why doctors move from a suspicious blood test to a marrow test within days, and why treatment often starts soon after.
Who gets it
AML can happen at any age, but it is more common in older adults. Most people have no clear cause. Earlier chemotherapy or radiotherapy, some other marrow conditions and heavy benzene exposure raise the risk a little. It is not caught from anyone, and it is rarely passed down in families.
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If AML is suspected, these cannot wait
Fever or shivering, bleeding that will not stop, blood in vomit, urine or stools, sudden breathlessness, severe headache, or confusion. Go to the nearest emergency department the same day or call 108. Take the blood report with you and say leukaemia has been mentioned. Do not wait for a clinic slot, and do not take fever tablets at home first to see if it settles.
Not sure whether this applies to you?
Ask an oncologistWhere the symptoms come from
What happens to the body when blasts crowd the marrow?
Most symptoms of AML are not caused by the blasts themselves. They come from the normal cells that the marrow can no longer make.
Too few red cells
Red cells carry oxygen. When haemoglobin falls, you feel tired, pale and short of breath on stairs. Some people notice a racing heart or dizziness when they stand up.
Too few working white cells
The total white count can be high, low or normal. What matters is that few of those cells can fight germs. Infections come often, last longer and can turn serious quickly.
Too few platelets
Platelets help blood clot. When they drop, you may see easy bruising, tiny red dots on the skin, bleeding gums or nosebleeds that take a long time to stop.
Blasts spreading outside the marrow
Less often, blasts collect in other places. This can cause swollen gums, skin lumps, bone pain or, rarely, problems in the brain and spinal fluid.
A very high white count can slow blood flow and is treated as an emergency.The first days
How does a doctor go from a blood test to a diagnosis?
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Complete blood count and smear
An ordinary blood test shows the counts. A trained person then looks at the blood under a microscope. If blasts are seen, you are usually referred to a haematologist the same day or the next.
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Bone marrow test
A small sample of marrow is taken from the back of the hip bone under local anaesthetic. It takes about half an hour. This is the test that confirms AML.
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Tests on the blast cells
The sample goes for flow cytometry, chromosome tests and gene tests. These tell the team which kind of AML it is. Some results come in days, others take longer.
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Checks on the rest of you
Heart scan, kidney and liver tests, and screening for infection. These decide how strong a treatment your body can safely take.
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The plan is discussed with you
Your team explains the kind of AML, the treatment it suggests and the reasons. Bring the family member who will make decisions with you.
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On your report
Which words will you see on an AML report?
- Blasts
- Young blood cells that have not grown up. A high share of them in the marrow or blood is the main sign of acute leukaemia.
- Myeloid
- The family of cells that becomes red cells, platelets and most white cells. It tells you this is not lymphoblastic leukaemia (ALL).
- Flow cytometry
- A lab test that reads markers on the surface of cells to tell which family the blasts belong to.
- Cytogenetics and molecular tests
- Tests for changes in chromosomes and single genes, such as FLT3 or NPM1. They shape the treatment plan.
- Remission
- No leukaemia can be seen in the marrow with standard tests and blood counts have recovered. It is the first aim of treatment, not the end of it.
Commonly believed
What do families often believe about AML, and what is true?
"We can wait a few weeks and get opinions first."
A second opinion is reasonable, but it should happen in days, not weeks. AML can change quickly, and some kinds need treatment started within a day or two. Ask the second team to see the reports urgently rather than booking a routine slot.
"Leukaemia is one disease with one treatment."
AML alone has many kinds, set by the gene changes in the blasts. One kind, acute promyelocytic leukaemia, is treated completely differently from the others. Two people with AML can have very different plans.
"It happened because of something we ate or did."
For most people there is no cause anyone can find. It is not caused by food, stress or a missed check-up, and nobody in the family could have prevented it.
"Older people cannot be treated at all."
Age alone does not decide. Fitness, other illnesses and the kind of AML matter more. Gentler treatments exist for people who cannot take intensive chemotherapy.
Being straight with you
How is AML treated, and what can this page not tell you?
Treatment is chosen for the person and the kind of AML. For people fit enough, it usually starts with intensive chemotherapy in hospital, called induction, to clear the blasts. Further treatment then keeps the leukaemia away, and for some people this includes a stem cell transplant.
Who intensive treatment does not suit
Intensive chemotherapy is hard on the heart, kidneys and body as a whole. For some older adults, or people with serious heart or lung disease, it can do more harm than good. Lower-intensity treatment, often given as a day patient, is then a real option rather than giving up.
What this page cannot tell you
It cannot tell you your own outlook. That depends on the gene changes in your blasts, your age and fitness, and how the leukaemia responds to the first round of treatment. Only your haematologist, with every report in hand, can talk about that honestly.
CION's haematology team reviews the reports, presents the case at a tumour board and coordinates transplant or specialised tests with qualified centres where needed.Questions we are asked
Common questions about AML
How fast does AML get worse without treatment?
It can change over days to weeks. Blood counts can fall quickly, and infection or bleeding can become serious fast. That is why doctors push for a marrow test and a plan within days. The pace differs between people, so your haematologist will tell you how urgent your own situation is.
Is AML the same as blood cancer?
AML is one kind of blood cancer. Others include acute lymphoblastic leukaemia, chronic leukaemias, lymphoma and myeloma. They start in different cells, behave differently and are treated differently, so the exact name on the report matters a great deal when you read anything about treatment.
Can AML be diagnosed from a blood test alone?
A blood test can raise strong suspicion, especially if blasts are seen. A bone marrow test is still needed in almost every case, because it confirms the diagnosis and gives the sample for the gene tests that decide treatment. Reference ranges differ between labs, so one result is always read with symptoms and repeat tests.
Is AML hereditary? Should my children be tested?
Most AML is not inherited. The gene changes happen in the blasts during a person's life and are not passed on. A small number of families do carry an inherited risk, especially where several relatives have had blood cancers. Tell your haematologist about your family history and ask whether testing makes sense.
Will the patient have to stay in hospital?
For intensive induction chemotherapy, yes, usually for several weeks, because counts fall very low and infections need quick treatment. Lower-intensity treatment is often given as a day patient with regular visits. Your team will explain which applies once the plan is set.
What is the difference between AML and ALL?
Both are acute leukaemias. AML starts in myeloid cells, which make red cells, platelets and most white cells. ALL starts in lymphoid cells, which make lymphocytes. ALL is more common in children and AML in adults. The medicines and schedules used are quite different.
Does everyone with AML need a bone marrow transplant?
No. A transplant is considered when the kind of AML carries a higher chance of coming back, or after a relapse, and when the person is fit enough. Many people are treated with chemotherapy alone. Ask your team early whether a transplant might be part of your plan, so family tissue typing is not delayed.
What should we bring to the first haematology visit?
Every blood report, including older ones, any marrow or scan reports, a list of current medicines and any past cancer treatment details. Bring the relative who will help with decisions. Write your questions down beforehand, because the first meeting carries a lot of information in a short time.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NHS — Acute myeloid leukaemia
- American Cancer Society — Acute Myeloid Leukemia (AML)
- National Cancer Institute — Adult Acute Myeloid Leukemia Treatment (PDQ) - Patient Version
- Cancer Research UK — Acute myeloid leukaemia (AML)
- National Health Mission — National Health Mission
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
AML Symptoms and Why Diagnosis Is Usually UrgentThe warning signs in adults, and what to do about themAML Subtypes: What the Classification MeansWhich kind of AML your report describesInduction Chemotherapy for AML: The First 30 DaysWhat the first round of treatment looks likeLeukaemia guideAll the leukaemias side by side
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Has AML been mentioned on a report?
Share the reports with us. CION's haematology team will tell you how urgent it is and what the next step should be. One helpline serves every CION centre.