Table of contents:
- What causes acute myeloid leukemia?
- What is AML?
- Role of bone marrow and white blood cells
- How leukemia interferes with blood cell counts
- Primary causes and risk factors of AML
- Genetic mutations and inherited syndromes
- Previous blood conditions
- Environmental exposures
- Demographic factors
- Certain medical treatments
- Symptoms that may be linked to AML development
- How causes influence prognosis and treatment
- Can AML be prevented?
- When to see a doctor
- Expert perspectives and ongoing research
- Frequently asked questions (FAQs)
- Supporting those diagnosed with AML
- LLS AML research impact
- Conclusion
- Sources
When someone is diagnosed with acute myeloid leukemia (AML), they may ask: why is this happening to me?
At The Leukemia & Lymphoma Society (LLS), we work hard to better understand the scientific causes of all blood cancers, including AML. And after decades of work, scientists are starting to get a better sense of how to answer that question.
What is AML?
Acute myeloid leukemia (AML) is a blood and bone marrow cancer that interferes with normal blood cell formation. Abnormal white blood cells multiply quickly, taking over space from normal cells and disrupting the body's functioning.
Role of bone marrow and white blood cells
AML begins in the bone marrow, the spongy tissue in which blood cells are produced. In AML, the bone marrow makes defective white blood cells that don’t function properly. These cells multiply and replace normal blood cells, which interferes with the body's ability to resist infection, carry oxygen, and stop bleeding.
How leukemia interferes with blood cell counts
As AML progresses, it leads to low blood cell counts, which can cause symptoms like fatigue, bruising, and frequent infections. This interference with the normal production of blood cells is what makes AML so serious and fast-moving (National Comprehensive Cancer Network, 2023).
Primary causes and risk factors of AML
While the causes of AML remain unclear, several key risk factors have been identified. These fall into five primary categories: genetic mutations and inherited syndromes, previous blood conditions, environmental exposures, demographic factors, and certain medical treatments (Shallis et al. 2019).
Genetic mutations and inherited syndromes
Certain genetic mutations significantly contribute to the development of AML. Key gene mutations such as FLT3, NPM1, and others are commonly associated with AML and can impact how the disease progresses. In addition, some individuals inherit conditions like Down syndrome, Fanconi anemia, or other genetic disorders that increase the risk of developing AML.
Genetic testing is an essential part of AML diagnosis and treatment planning. Understanding a patient’s specific mutations helps doctors determine the likely course of the disease and select targeted therapies when available.
Previous blood conditions
Individuals with myelodysplastic syndromes or other blood disorders are at a higher risk of developing AML. These pre-existing conditions affect the bone marrow’s ability to produce healthy blood cells, making it more prone to malignant transformation.
Environmental exposures
- Benzene exposure: Benzene is a carcinogen found in industrial solvents, gasoline, and some household products. Prolonged exposure to benzene is known to increase the risk of developing AML.
- Radiation exposure: People with high levels of radiation exposure, such as survivors of atomic incidents or those undergoing specific cancer treatments, have an elevated risk of developing AML.
- Cigarette smoking: The toxins in cigarette smoke can damage the DNA in bone marrow cells, significantly increasing the risk of AML.
Demographic factors
AML is more prevalent in people who are older than 60. As we age, our cells divide and repair themselves many times. Over time, small errors can occur, which may lead to genetic changes. Although AML occurs in people of any age, older people are at higher risk because they have had more exposure to risk factors for longer durations (National Comprehensive Cancer Network, 2023).
Additionally, AML is more common among males compared to females (National Cancer Institute, 2025).
Certain medical treatments
Secondary AML can develop after chemotherapy or radiation therapy used to treat other cancers. These treatments, especially those using specific drugs like alkylating agents or topoisomerase II inhibitors, can harm the bone marrow's genes, which may result in AML developing years later.
However, secondary AML is relatively uncommon. While the risk is real, it typically affects a small percentage of patients who receive these treatments. The likelihood can depend on several factors, including the specific drugs used, dosage, length of treatment, and a person's underlying genetic risk.
Doctors carefully consider these risks when planning treatment, and for most patients, the benefits of cancer therapy far outweigh the small chance of developing secondary AML.
If you have concerns, talk with your healthcare provider. In some cases, genetic testing or long-term monitoring may offer added reassurance.
Symptoms that may be linked to AML development
It is not unusual for an AML patient to experience a loss of well-being due to a shortage of normal, healthy blood cells. This occurs when the leukemia cells in the bone marrow drive out the regular blood-producing cells. Consequently, patients with AML might lack sufficient mature red blood cells, white blood cells, and/or platelets. As such, they usually have signs and/or symptoms associated with low blood cell counts (Leukemia & Lymphoma Society, 2023).
Other potential symptoms include:
- Pale or sallow skin
- Shortness of breath
- Prolonged bleeding
- Fever without infection
If you or someone you know is exhibiting any of these symptoms, contact a healthcare provider.
How causes influence prognosis and treatment
Understanding what causes AML is vital in shaping treatment plans. For instance:
- Gene mutations such as NPM1 are linked to better outcomes and specific treatment regimens (Döhner et al. 2022).
- Therapy-related AML often requires more aggressive or novel therapies due to its resistance (Tallman et al. 2019).
- Age and prior conditions may influence whether a patient qualifies for intensive treatments or clinical trials (Medeiros et al. 2019).
LLS supports research into personalized therapies, ensuring everyone receives the most effective care based on their unique disease profile.
Can AML be prevented?
Although there is no way to prevent AML altogether, there are some ways to lower the risks. The initial step is reducing exposure to recognized environmental risks:
- Avoid benzene: This chemical is present in industrial settings and cigarette smoke.
- Limit radiation exposure: Only undergo radiation therapy or diagnostic scans when medically necessary. These treatments, while effective and often essential to treat cancer, can sometimes damage healthy cells in the bone marrow, leading to AML down the line.
- Please note: While this elevated risk is real, the benefits of life-saving treatments, such as CAR T-cell therapy or other cancer therapies, often far outweigh the potential risks. In many cases, these treatments are crucial for improving survival and quality of life.
- Quit smoking: Cigarettes introduce numerous toxins into the body that can damage bone marrow.
For those with a family history of genetic illness or prior blood disorders, genetic counseling and monitoring blood can help with early recognition.
When to see a doctor
Early detection can be a major factor. It's important to talk to a doctor if you or someone around you notices:
- Unexplained fatigue
- Frequent infections
- Easy bruising or bleeding
- Shortness of breath
- Persistent fever
In case there is a known history of blood diseases, previous cancer treatments, or genetic syndromes, checkups and blood tests are highly advised.
Expert perspectives and ongoing research
Modern breakthroughs in genetic research have greatly advanced our understanding of AML. Scientists have identified key mutations, including those in IDH1, IDH2, and TP53, that play a central role in how AML develops and behaves:
“Understanding the genetic basis of AML is critical to advancing new treatments. Identifying mutations and molecular pathways helps us tailor therapies to patients, improving outcomes and quality of life.” — LLS Research Team
This growing knowledge is now shaping the future of AML care, with new treatments designed to target these specific mutations allowing for more precise, personalized approaches. Precision medicine is refocusing efforts on helping clinicians select the optimal treatment for an individual based on their unique genetic profile.
This approach has the potential to increase survival rates and overall quality of life for AML patients. With ongoing funding of genetic and molecular research, LLS is moving treatment planning forward and giving new hope to AML-affected individuals.
Frequently asked questions (FAQs)
- What is the main cause of AML? The main cause is genetic mutations that result in abnormal growth of myeloid cells in the bone marrow.
- Is AML hereditary? The majority are not inherited, but people with conditions such as Down syndrome or Fanconi anemia have an increased inherited risk.
- Can chemical exposure cause leukemia? Yes. Chemical exposure to substances such as benzene has been found to raise the likelihood of leukemia, especially AML.
- How does AML start in the body? It develops in the bone marrow when immature cells do not mature and multiply out of control, which interferes with the normal production of blood cells.
- Who is most at risk for AML? Older people, those with a history of blood disorders, those who have been exposed to radiation or chemicals, and those with specific genetic syndromes are at the greatest risk.
- Can lifestyle changes reduce risk? Yes. Quitting smoking, avoiding chemical exposure, and maintaining a healthy lifestyle can reduce overall cancer risk, including AML.
Supporting those diagnosed with AML
An AML diagnosis can be overwhelming for the individual diagnosed and their loved ones. If you know someone who is affected by AML, here's how you can offer support:
- Listen actively: At times, simply being present is the greatest support.
- Educate yourself: Learn about AML to learn more about what your loved one is going through.
- Encourage medical follow-ups: Assist with scheduling appointments and transportation if necessary.
- Provide emotional support: Join support groups or therapy together as necessary.
LLS provides ample resources to families, such as counseling, peer support, and financial support.
LLS AML research impact
LLS plays a leading role in uncovering the biological, genetic, and environmental factors behind AML.
- Funding key research: LLS funds cutting-edge studies aimed at identifying the genetic mutations and cellular pathways involved in AML development. By supporting this foundational science, LLS helps researchers uncover how and why certain cells become cancerous—and how to stop it.
- Improving risk stratification: LLS supports efforts to better define risk groups based on inherited conditions, chromosomal abnormalities, and acquired mutations. These insights are key to developing more personalized treatment strategies.
- Educating and supporting patients: LLS empowers patients and families with knowledge about AML’s possible causes and risk factors, from genetic predispositions to environmental exposures. Resources include access to clinical trials, expert support, and personalized education.
- Policy and advocacy: LLS’s Office of Public Policy (OPP) is dedicated to advancing a policy agenda that accelerates the development of treatments and addresses the barriers patients encounter when seeking care.
Every step towards understanding AML’s causes brings us closer to more effective prevention and treatment strategies, made possible by ongoing support for LLS’s mission.
Conclusion
Understanding the causes of acute myeloid leukemia (AML) is key. While some risk factors— such as genetics and age—cannot be changed, others—like certain environmental exposures or health behaviors—may be influenced by individual or societal circumstances.
LLS strives to help anyone affected by AML via access to the newest research, latest treatments, and a positive prognosis for the future. Together, we can continue to make progress in AML treatment and provide hope to those who need it most.
About the author: Dr. Ali is a medical journalist and copywriter.
Sources
Döhner, H., A.H. Wei, F.R. Appelbaum, et al. "Diagnosis and Management of AML in Adults: 2022 Recommendations from an International Expert Panel on Behalf of the ELN." Blood 140, no. 12 (2022): 1345-1377. https://doi.org/10.1182/blood.2022016867.
Leukemia & Lymphoma Society. Acute Myeloid Leukemia in Adults. Revised June 2023. https://lls.org/sites/default/files/2023-06/PS32_Adult_AML_2023.pdf.
Medeiros, B. C., Chan, S. M., Daver, N. G., Jonas, B. A., & Pollyea, D. A. (2019). Optimizing survival outcomes with post‐remission therapy in acute myeloid leukemia. American Journal of Hematology, 94(7), 803–811. https://doi.org/10.1002/ajh.25484.
National Cancer Institute. 2025. SEER Cancer Statistics: Cancer Stat Facts. Accessed April 23, 2025. https://seer.cancer.gov/statistics-network/explorer/application.html.
National Comprehensive Cancer Network. NCCN Guidelines: Acute Myeloid Leukemia, version 3.2023, April 5, 2023. www.nccn.org.
Shallis, R. M., Wang, R., Davidoff, A., Ma, X., & Zeidan, A. M. (2019). Epidemiology of acute myeloid leukemia: Recent progress and enduring challenges. Blood Reviews, 36, 70–87. https://doi.org/10.1016/j.blre.2019.04.005.
Tallman, Martin S., Eunice S. Wang, Jessica K. Altman, Frederick R. Appelbaum, Vijaya Raj Bhatt, Dale Bixby, Steven E. Coutre, et al. 2019. “Acute Myeloid Leukemia, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.” Journal of the National Comprehensive Cancer Network 17 (6): 721–49. https://doi.org/10.6004/jnccn.2019.0028.