What causes acute myeloid leukemia is a question that continues to drive medical research and public awareness in 2025. Acute myeloid leukemia, often called AML, is a fast-growing cancer of the blood and bone marrow that affects thousands of adults and children in the United States each year. While scientists have made major progress in understanding its biology, the exact cause remains complex — involving both genetic changes and environmental exposures.
This article takes a detailed look at the confirmed factors known to contribute to AML’s development and the most recent insights from medical research.
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What Is Acute Myeloid Leukemia?
Acute myeloid leukemia is a type of cancer that begins in the bone marrow, where blood cells are produced. In healthy individuals, the bone marrow makes immature cells that mature into red blood cells, white blood cells, and platelets.
In AML, something goes wrong during this process. The body starts producing abnormal white blood cells — called myeloblasts — that don’t mature properly. These cells multiply quickly, crowding out healthy ones and leading to anemia, infection, and bleeding problems.
While AML can occur at any age, it most often affects adults over 60. Recent statistics from U.S. cancer registries show roughly 20,000 new cases diagnosed annually, with survival rates improving as treatments advance.
Understanding the Causes: The Role of DNA Changes
At its core, AML begins with genetic changes inside bone marrow cells. These changes — mutations or chromosomal abnormalities — affect how cells grow and divide.
Scientists have identified several key genetic mutations commonly seen in AML patients. These include changes in genes such as:
- FLT3 – Involved in cell growth; mutations here are linked to more aggressive forms of AML.
- NPM1 – One of the most frequently mutated genes; can affect prognosis and treatment response.
- IDH1 and IDH2 – Mutations in these genes alter cell metabolism, leading to uncontrolled growth.
- RUNX1 and CEBPA – Affect normal blood cell development.
These mutations can occur randomly or as a result of environmental exposure. Once they appear, they cause immature cells to multiply instead of maturing, eventually leading to leukemia.
Environmental and Lifestyle Risk Factors
Although AML isn’t considered a lifestyle-related cancer, research has identified several environmental and medical factors that increase risk.
1. Long-Term Exposure to Benzene
Benzene, a chemical used in the manufacturing of plastics, rubbers, and fuels, has been linked to leukemia for decades. People with long-term occupational exposure — such as workers in chemical plants, oil refineries, or those regularly exposed to exhaust fumes — face a higher risk of developing AML.
2. Previous Cancer Treatments
Patients treated with certain chemotherapy drugs or radiation therapy for other cancers can later develop AML. This form is known as therapy-related AML (t-AML). Drugs such as alkylating agents and topoisomerase II inhibitors have been identified as common triggers.
3. Tobacco Use
Smoking is one of the most preventable risk factors. The benzene and other carcinogens in cigarette smoke can damage bone marrow DNA, raising the likelihood of AML.
4. Exposure to Radiation
High levels of radiation — such as from nuclear accidents or medical treatments — are associated with a higher chance of developing AML. However, normal diagnostic imaging like X-rays or CT scans does not pose significant risk.
5. Workplace and Environmental Hazards
Some industrial workers, including those in petrochemical, paint, or rubber industries, may face elevated risk due to chemical exposure. Strict safety standards have reduced these risks, but they remain relevant in certain environments.
Medical Conditions That Increase Risk
Certain health conditions can also predispose individuals to developing AML later in life.
- Myelodysplastic Syndromes (MDS): A group of bone marrow disorders that sometimes evolve into AML.
- Aplastic Anemia: A rare condition where the bone marrow fails to produce enough blood cells.
- Genetic Syndromes: People with inherited disorders like Down syndrome, Fanconi anemia, or Bloom syndrome have a higher chance of developing AML.
These conditions highlight the importance of early monitoring in individuals with known genetic or hematologic risk factors.
Age and Gender Trends
Age is one of the strongest predictors of AML risk. While the disease can occur in children, the median age of diagnosis in the U.S. is around 68 years. The likelihood increases steadily with age due to the accumulation of genetic changes over time.
Men are slightly more likely than women to develop AML, though the reasons remain unclear. Hormonal differences, occupational exposure patterns, and genetic factors may contribute.
Can AML Be Inherited?
Most cases of AML are not inherited directly. The genetic mutations that drive AML typically occur during a person’s lifetime rather than being passed down from parents.
However, some rare hereditary conditions can increase risk. Families with a history of blood cancers may carry mutations that make bone marrow cells more vulnerable to transformation. Genetic counseling and testing can help identify at-risk individuals and guide early surveillance strategies.
Recent Research and Discoveries in 2025
Advances in genetics and molecular medicine have provided new insight into how AML develops and how to target it. Researchers continue to identify patterns in DNA mutations that predict treatment response and long-term outcomes.
Some of the most promising current research areas include:
- Targeted Therapy Development: Drugs that specifically inhibit mutated genes, such as FLT3 or IDH inhibitors, have improved survival rates for certain AML types.
- Epigenetic Studies: Scientists are studying how environmental factors influence gene expression, potentially triggering leukemia without altering DNA directly.
- Immune-Based Approaches: New immunotherapies are being tested to help the immune system recognize and destroy leukemia cells.
- Precision Medicine: Personalized treatment plans based on genetic testing now allow doctors to tailor therapy for each patient, reducing side effects and improving effectiveness.
These breakthroughs have transformed AML care, offering more patients remission and longer survival than ever before.
Reducing Risk and Promoting Awareness
While AML cannot always be prevented, certain steps can reduce exposure to known risk factors:
- Avoid smoking and secondhand smoke.
- Minimize contact with industrial chemicals such as benzene.
- Follow all workplace safety standards if working with hazardous materials.
- Maintain regular health checkups, especially for those with prior chemotherapy or bone marrow conditions.
- Seek medical advice if symptoms such as fatigue, frequent infections, or unexplained bruising occur.
Early diagnosis remains one of the most effective ways to improve outcomes. Because AML progresses quickly, recognizing the warning signs and seeking prompt evaluation can make a significant difference in treatment success.
Outlook and Hope for the Future
The medical community’s understanding of AML continues to grow rapidly. With improved diagnostics, better treatment options, and ongoing genetic research, the outlook for patients has become far more hopeful than it was even a decade ago.
Doctors now have tools to identify the exact mutations driving each case of AML, allowing for highly personalized care. This shift from one-size-fits-all treatment to individualized therapy represents a major leap forward in leukemia management.
Acute myeloid leukemia remains a serious but increasingly treatable disease. By understanding its causes, risks, and warning signs, more people can take proactive steps toward early detection and informed care