Symptoms at presentation are usually non-specific. The following symptoms should be investigated:

• fatigue, pallor or other symptoms of anaemia
• symptoms of serious infection, such as tachycardia, high fevers, rigors
• unresolving or unusual infection or fever
• abnormal bleeding or bruising
• sore gums or mouth ulcers
• unexplained bone pain
• unintentional weight loss
• unexplained fevers.

The following signs and symptoms require consultation as a medical emergency:

• sepsis
• symptomatic anaemia
• severe thrombocytopenia < 20 × 109/L
• major laboratory abnormalities
• very high white cell count (> 50 × 109/L) or signs of hyperviscosity, such as visual disturbance, confusion, severe headache or breathlessness
• spontaneous/uncontrolled bleeding
• coagulopathy.

People with AML may only have mild symptoms. It is not uncommon that a patient with few or no symptoms is diagnosed unexpectedly on a blood test conducted in primary care.

The presence of multiple signs and symptoms listed above is highly suggestive of AML, particularly in people with a history of an underlying pre-disposing haematological condition.