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2591 pages added, reviewed or updated during the last month (last updated: 16/4/2021)

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clinical features of AML

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Presentation of AML is usually with signs and symptoms caused by leukemic infiltration of the bone marrow and extramedullary sites (1).

  • signs and symptoms of pancytopenia
    • anaemia - fatigue, exertional dyspnoea, palpitations, angina or claudication
    • thrombocytopenia - epistaxis, gingival haemorrhage, menorrhagia, cutaneous petechiae or occasionally significant gastrointestinal ,urinary or intracranial haemorrhage
    • neutropaenia

  • infections which are usually bacterial or fungal and common sites for sepsis include the teeth and oropharynx, sinuses, lung, skin, perineum and bowel

  • fever - presenting feature in around 15-20% of patients

  • disseminated intravascular coagulation - although seen at presentation of all AML subtypes, it is much more common in childhood acute promyelocytic leukaemia (APL)

  • infiltration of extramedullary sites can present as
    • lymphadenopathy
    • hepatosplenomegaly
    • in CNS - involvement at diagnosis is seen in 15% of patients and usually manifests as leptomeningeal disease with headache and isolated cranial nerve palsies (especially V and VII), and intracranial masses
    • in skin (leukaemia cutis) - occurs in about 10% of cases
    • gingival infiltration
    • testicular involvement - rarely

  • features of hyperviscosity such as dyspnoea, hypoxia, respiratory failure, headache seizures, confusion, coma visual disturbances or priapism due to leucostasis is seen in patients who present with a blast count >50×109/l


Last reviewed 01/2018