Living With Acute Myeloid Leukemia (AML)

This page is for people living with AML and the people who care for them. It covers treatment phases, infection and fever, transfusions, hospital stays, and support.

Acute myeloid leukemia, or AML, is a fast-growing cancer of the blood and bone marrow. Unlike some blood cancers, AML usually needs treatment quickly. One subtype, acute promyelocytic leukemia, is treated on its own pathway. Day-to-day life with AML often means time in the hospital, close monitoring, and careful attention to infection risk. This is especially true in the weeks right after diagnosis.

The first phase is called induction. Its goal is to clear leukemia cells from your blood and bone marrow as quickly as possible. The second phase, consolidation, follows once you are in remission. It targets any remaining leukemia cells that could cause a relapse later. Together, these phases can mean weeks in the hospital. Your blood counts drop very low during this time and need close medical support.

That is the intensive route, but not everyone takes it.

• Acute promyelocytic leukemia is treated on a separate pathway that looks very different.
• People who are older or less fit, or whose molecular results point elsewhere, are often given less-intensive drug treatment.
• Whether a stem cell transplant is planned also changes the plan.

Ask your leukemia team which route you are on before you make plans around it.

AML itself crowds out healthy blood cells. Treatment lowers your counts further, on purpose, to kill leukemia cells. This combination leaves you with very little natural infection defense for a stretch of time. Antibiotics and antifungal medicines are often used during this period to prevent or treat infections before they become dangerous.

CDC says to call your doctor immediately if you have a temperature of 100.4°F (38°C) or higher. It says a fever during chemotherapy is a medical emergency. Do not wait it out at home. If you are in the hospital, tell your nurse right away. If you are at home, call your team. If you cannot reach them quickly, go to the ER or call 911. Tell the check-in staff that you are having cancer treatment.

Red blood cell and platelet transfusions are a routine, expected part of AML treatment. They are not a sign that something has gone wrong. They replace blood cells destroyed by the leukemia and by chemotherapy, while your bone marrow recovers. Your team gives them when your counts and your symptoms call for it, so how many you need varies widely.

After treatment, your team continues checking your blood and bone marrow regularly, even once you are in remission. These tests show whether your counts stay normal, or whether leukemia cells are starting to come back. This testing continues for a while after treatment ends, because AML can come back (relapse) even after a good first response.

Many people with AML spend long stretches in the hospital, especially during induction. It can feel disorienting, on top of an already frightening diagnosis. Ask your care team what a typical stay looks like. This helps you and your family plan around work, childcare, and other responsibilities. Bring comfort items from home if your unit allows it. Your own pillow, photos, or music can make a hospital room feel less clinical.

A diagnosis this intense affects the whole household, not just the person with AML. Ask your hospital's social worker about support for caregivers and children at home. Ask about practical help too, like meals, transportation, or work leave. Many cancer centers also connect patients with peer support. That means other people who have been through AML treatment, who can speak to what it is actually like.

Call your care team immediately for a fever of 100.4°F (38°C) or higher, new bleeding or bruising, shortness of breath, or a feeling of severe fatigue that comes on quickly. These can be signs of infection, low blood counts, or a change in your leukemia that needs urgent attention. For emergencies, such as severe trouble breathing or bleeding that will not stop, call 911 or go to the ER.

• What should I expect during induction and consolidation, and how long does each usually last?
• How will you manage infection risk while my counts are low?
• How often will I need blood tests once I am in remission?
• What would prompt a bone marrow test to check for relapse?

• National Cancer Institute — Acute Myeloid Leukemia Treatment (PDQ).
• National Cancer Institute — Infections in People with Cancer.
• CDC — Watch Out for Fever.