The signs and symptoms of acute myeloid leukemia (AML) can vary. In most cases they develop rapidly. Sometimes, symptoms can develop slowly depending on how much the leukemia cells have spread inside the bone marrow and to other organs. Severe infection is often the first symptom in children with AML.
Common symptoms include:
- fever
- unusually pale skin (pallor)
- weakness and fatigue
- weight loss
- loss of appetite leading to less eating (anorexia)
- enlarged liver, spleen, and lymph nodes; this happens in more than half of patients diagnosed with AML
- red or violet bumpy lesions that appear in the skin, called subcutaneous nodules; this happens when leukemia cells enter the skin. Subcutaneous nodules are more commonly seen in infants.
Other less common symptoms include:
- bone pain
- sore throat and cough
- abdominal pain
- swelling of the gums (gingival hypertrophy)
Chloromas
When myeloblasts (a clump of mutated young bone marrow cells that cannot develop into normal blood cells) spread and accumulate in other parts of the body, they are referred to as chloromas. Rarely, chloromas can accumulate in the eye orbit, causing the eyes to swell.
Even more rarely, chloromas can spread to the spinal cord, causing it to compress. This causes either back pain or lumps along the spinal cord.
Are some symptoms more severe in AML than ALL?
Bleeding is often more pronounced in children with AML. This is because the blood cannot clot properly. This is called coagulopathy associated with AML.
Infections and any of the symptoms related to hyperleukocytosis can also be more pronounced in children with AML.
Leukostasis syndrome
In rare cases, leukemic cells can multiply into extremely large numbers (hyperleukocytosis). When large clumps of leukemic cells enter small blood vessels, they can cause problems in other parts of the body such as the lungs, nervous system, heart and/or eyes. This is called leukostasis syndrome.
Leukostasis syndrome can cause various symptoms in different parts of the body. If your child develops any of these symptoms, take them to emergency right away.
- shortness of breath: this happens when tissues inside the body are not getting enough oxygen, causing a condition called hypoxia
- coughing
- headache, vertigo, hearing loss
- unbalanced walking (ataxia)
- double vision
- confusion
- fainting
- seizures
- drowsiness
- swelling of limbs
- chest pain, which happens when the heart is not getting enough blood; this is called angina
- abnormal heart beats
- hemorrhage (bleeding) in the retina, which is the light-detecting layer at the back of the eye
- retinal vein thrombosis (blockage of a vein in the retina)
Other symptoms of leukostasis syndrome include bleeding from the mouth, nose, gut, lungs, or brain. The kidneys may also be affected.
Tumour lysis syndrome
Hyperleukocytosis can also cause leukemic cells to release substances such as uric acid, potassium, and phosphate into the blood. This is known as tumour lysis syndrome. In children with hyperleukocytosis, this can be severe. If untreated, this can potentially lead to kidney failure.
Your child requires immediate medical attention if they develop any of the above symptoms.