Frequently Asked Questions

What is AML?

Acute myeloid leukemia (AML) is a cancer of the cells of the blood. Your blood is made up of three main types of cells: red blood cells, white blood cells, and platelets. Red blood cells, also called erythrocytes, carry oxygen throughout the body. White blood cells, also called leukocytes, help your body fight infections. Platelets help stop bleeding. Most of these cells are created in the bone marrow.

In AML, a change occurs in some of the cells in your bone marrow that stops them from maturing into functional cells. These immature blood cells rapidly accumulate in the bone marrow and prevent your body from making new healthy red blood cells, white blood cells, and platelets. The symptoms of AML are caused by a lack of mature blood cells.

  • Anemia is caused by a lack of red blood cells. Anemia may make you feel tired and short of breath.
  • Infections are caused by a weakened immune system from a lack of functioning white blood cells. Infections in AML can be life-threatening.
  • Bleeding is caused by a lack of platelets. You may get nose bleeds, bruised gums, or heavy menstrual cycles if your platelet levels are low.


NCCN Guidelines for Patients. Acute Myeloid Leukemia. Accessed March 20, 2019.

What questions should I ask my doctor about my diagnosis and treatment?

Talking often with your healthcare team and asking questions are important for making informed decisions about your health. There is no one-size-fits-all approach to treating AML. It is vital that you receive personalized information about your cancer and health. Many people feel anxious about questioning their doctor or worried that they may not understand medical terms. The following strategies may help you talk to your doctor and get the information you need:

  • Take someone with you to doctor visits who can take notes, listen, and ask questions.
  • Ask as many questions as you need to. Write down your questions and bring them with you to appointments.
  • Remember that all of your questions are important. There is no such thing as a silly question when it comes to understanding your health.
  • Ask the doctor to explain any medical terms you don’t understand and write down any terms you don’t know.
  • Repeat back the information the doctor gives you in your own words to make sure you understand it.

The following is a list of questions about AML that you may want to ask your doctor. Remember to write down any additional questions you have about your own health and bring them with you to your appointment.

  • Is this a fast- or slow-growing leukemia?
  • What were the results of my tests? How do the results impact my prognosis and treatment?
  • Will I be treated immediately for my cancer or will you monitor my cancer over time for progression?
  • What symptoms indicate that my cancer is getting worse?
  • How do my age, health, and other factors affect my treatment options?
  • What are my treatment options? What are the benefits and risks of each option?
  • Will I need any vaccinations because of my condition? Will I not be able to have certain vaccinations?
  • What can be done to relieve or prevent the side effects of treatment?

For a list of additional questions, please see the references below.

National Comprehensive Cancer Network. NCCN Guidelines for Patients. Acute Myeloid Leukemia. Accessed March 20, 2019.

American Cancer Society. Questions to Ask Your Doctor When You Have Cancer. Accessed March 20, 2019.

Do I need to stay in the hospital during treatment?

For many people diagnosed with AML, treatment needs to begin as soon as possible after diagnosis because the disease progresses very quickly. The initial phase of treatment is referred to as induction therapy and usually consists of chemotherapy. The chemotherapy you receive will depend on your age, your health, and characteristics of your particular cancer. Usually the chemotherapy will be given over a week-long period. It then takes 2 to 4 weeks for your bone marrow to recover and begin producing normal blood cells again. This induction phase is almost always performed while you stay in the hospital because you will need frequent monitoring and supportive care with IV antibiotics and transfusions.


Larson RA [UptoDate]. Patient education: Acute myeloid leukemia (AML) treatment in adults (Beyond the Basics). Accessed March 20, 2019.

What is a bone marrow test?

In order to diagnose AML, a sample of your bone marrow must be removed and tested. Your bone marrow may also be tested during treatment to see if your cancer therapy is working.

To remove a sample of bone marrow, your doctor will first numb your skin. There are two procedures that may be used to remove a sample. The first is called bone marrow aspiration. A hollow needle will be pushed through your skin and into the bone to remove a small amount of liquid bone marrow. Another procedure is a bone marrow biopsy. For a biopsy, a wider needle is used to remove a piece of sample.

These procedures are often done on the back of the hip. You may feel bone pain at your hip for a few days and your skin may bruise after the procedure.


NCCN Guidelines for Patients. Acute Myeloid Leukemia. Accessed March 20, 2019.

What is the difference between induction and consolidation?

Treatment for AML can occur over a period of years and often involves several phases of therapy.

  • Induction is the first phase of treatment. How intensive this treatment will be depends on factors such as your age, health, and if you have other underlying conditions. Standard therapy is to receive 2 to 4 chemotherapy drugs for 3 to 10 days. The goal of the induction phase is to reduce the number of leukemia cells in the body.
    • Monitoring for treatment results will be performed frequently through blood tests. Bone marrow samples will also be needed periodically to check to see how many blasts (immature blood cells) are present. The number of blasts will let your doctor know if the induction chemotherapy worked. Bone marrow samples are usually tested 2 or 3 weeks after the start of chemotherapy, but may be taken 3 to 4 months after low-intensity chemotherapy.
    • Re-induction is another round of chemotherapy after you have completed the induction phase. Patients will only receive re-induction therapy if a bone marrow sample shows the presence of blasts after induction.
    • Recovery is a period after induction where you will not receive treatment and your bone marrow will begin to make normal blood cells again. Patients will only enter this recovery phase if there were no blasts in their marrow sample.
    • A complete remission is an absence of all signs and symptoms of AML. In complete remission, blood counts have returned to normal and there are no blasts in the marrow.
  • Consolidation is the second phase of treatment. It may also be referred to as post-remission therapy. During consolidation, you will receive chemotherapy to treat any remaining blasts that have survived the induction phase. You may receive the same drugs used during induction, or you may receive one of the drugs at a higher dose. A blood stem cell transplant may also be an option, particularly if you are at high risk for the leukemia returning.
    • Maintenance is the final phase of treatment and may be needed for years.
    • Surveillance is a period of testing that monitors for signs that leukemia is returning. You will have a blood test every 1 to 3 months for 2 years, followed by blood tests every 3 to 6 months for another 3 years. A bone marrow test may be needed if the blood test results are not normal.
    • Relapse is the return of leukemia. You will receive treatment again with the goal of achieving remission.


NCCN Guidelines for Patients. Acute Myeloid Leukemia. Accessed March 20, 2019.

What is a stem cell transplant?

Stem cells are precursor cells that divide to become the specialized cells of the body. Blood stem cells are found in the bone marrow and divide into cells that are destined to eventually become either red blood cells, white blood cells, or platelets. In AML, these precursor cells remain immature and do not develop into specialized cells.

Blood stem cell transplants replace damaged stem cells with healthy stem cells. This treatment may also be referred to as hematopoietic stem cell transplant (HSCT). A transplant is an option for the consolidation phase or for relapsed patients. It should not be used for induction.

Before the transplant, you will receive treatment that destroys your damaged stem cells in the bone marrow. The death of these cells makes room for the transplanted cells but also kills remaining AML cells. The treatment will also weaken your immune system so that your body won’t attack the donor stem cells. The donor cells will come from a healthy person who may or may not be related to you. This is called an allogeneic transplant. The donor cells will form new bone marrow with healthy stem cells, and you will begin to create normal blood cells again.


NCCN Guidelines for Patients. Acute Myeloid Leukemia. Accessed March 20, 2019.

Will chemotherapy affect my fertility?

Some cancer treatments may affect your ability to conceive a child naturally. It is important to ask your doctor about the effects of your treatment before therapy begins. Some risk factors that impact your fertility include your age at diagnosis, the type and dosage of chemotherapy you receive, and the location and dosage of radiation. Radiation exposure to the ovaries, testes, or pituitary gland may reduce your chances of conceiving. Stem cell transplants are also associated with a high risk of infertility. Ask your doctor about the possibility of freezing your eggs or sperm for future use.


Leukemia and Lymphoma Society. Fertility. Accessed March 20, 2019.

I received chemotherapy and radiation for a previous cancer. How does this impact my AML prognosis?

Chemotherapy can damage the DNA of normal cells, increasing the risk of a different cancer developing later on. Some types of chemotherapy have been linked to the development of a second cancer years after the treatment for an initial cancer.

  • Alkylating agents increase the risk of developing AML. The risk begins to increase 2 years after treatment and peaks between 5 to 10 years before declining. Unfortunately AML associated with previous alkylating agent exposure tends to be harder to treat. Examples of alkylating agents include mechlorethamine, chlorambucil, cyclophosphamide, melphalan, lomustine, carmustine, and busulfan.
  • Platinum-based chemotherapy increases the risk of AML. This leukemia tends to be hard to treat. Platinum-based chemotherapy drugs include cisplatin and carboplatin.
  • Topoisomerase II inhibitors are associated with an increased risk of AML, with most cases diagnosed within 2 to 3 years after treatment started. These leukemias tend to respond better to treatment and have a better outlook than leukemia from alkylating agents. Examples of topoisomerase inhibitors include etoposide, teniposide, mitoxantrone, doxorubicin, daunorubicin, epirubicin, and idarubicin.


American Cancer Society. How does chemotherapy affect the risk of second cancers? Accessed March 20, 2019.

What is tumor lysis syndrome?

Tumor lysis syndrome (TLS) is a life-threatening emergency that may occur after treatment for a fast-growing cancer, such as leukemia. TLS is caused by the rapid death of cancer cells after treatment. When the tumor cells die, they suddenly release their contents into the blood, which can potentially damage organs such as the kidneys, liver, heart and nervous system. If you are at high risk of TLS, you will receive your cancer therapy in the hospital so that you can be monitored for signs of TLS.


In order to prevent TLS, you will receive intravenous (IV) hydration as well as medications that lower the level of uric acid in the blood, such as allopurinol or rasburicase.


Risk factors for TLS include high white blood cell counts, high uric acid levels, kidney problems, dehydration, or late-stage cancers.


Let your doctor know immediately if you experience any signs or symptoms of TLS, including nausea and vomiting, diarrhea, swelling, shortness of breath, irregular heartbeat, cloudy or bloody urine, decrease in urine amount, back pain behind the lower ribs, weakness or low energy, seizures, muscle spasms or cramps, or pain in the joints. When to Call the Doctor During Cancer Treatment. Accessed March 20, 2019.

How do I find a support group for AML?

Support groups can be an important resource for people diagnosed with AML. They provide a safe space to discuss your difficulties, feelings, and concerns with others who understand how you feel. No one support group is right for everyone and it is important that you find one that makes you feel comfortable. Some groups are specifically focused on AML, while others may include people with any type of cancer. They also vary in format, from online or telephone support groups to in-person meetings. Some may even involve social workers to help patients cope with issues. You can find support groups in your area through an online search or by asking your doctor or the staff of a local hospital. Use the resources below to begin your search:


CancerCare. Blood Cancers Patient Support Group. Accessed March 20, 2019.


Leukemia and Lymphoma Society. Support Groups. Accessed March 20, 2019.


Cancer Support Community. Find Support. Accessed March 20, 2019. Finding Support and Information. Accessed March 20, 2019.


American Cancer Society. Support Programs and Services. Accessed March 20, 2019.