What causes acute myeloid leukemia has remained one of the most pressing questions in modern cancer research. This fast-developing blood cancer affects the bone marrow — the body’s blood cell factory — and can progress rapidly if untreated. Over the past few years, major advances in genetic and environmental studies have helped uncover the factors that contribute to its development, giving doctors and patients clearer insight into how the disease starts and who is most at risk.
In 2025, researchers continue to focus on the underlying mechanisms behind this complex cancer, combining data from molecular genetics, lifestyle studies, and environmental health to better understand its origins.
Understanding the Disease
Acute myeloid leukemia, or AML, starts in the bone marrow, where new blood cells are made. Normally, the bone marrow creates immature cells that grow into healthy red blood cells, white blood cells, and platelets.
In AML, this process breaks down. Instead of maturing, the cells become stuck in an early stage of development. These immature cells, called myeloblasts, multiply uncontrollably, crowding out normal cells and disrupting the body’s ability to fight infection, carry oxygen, and stop bleeding.
The disease is “acute” because it progresses quickly, often requiring immediate treatment once diagnosed. Although AML can occur at any age, it’s most common among adults over 60.
How AML Develops at the Cellular Level
The root of AML lies in DNA mutations that affect how blood-forming cells grow and divide. These mutations can occur spontaneously or be triggered by external exposures over time.
Inside the bone marrow, stem cells constantly divide to make new blood cells. Occasionally, errors occur during this process. When those errors affect key genes that control cell growth or repair, the cells begin to behave abnormally.
Instead of dying or maturing as they should, these cells multiply without regulation. Over time, they replace healthy blood cells and spread through the bloodstream to other organs.
Genetic Mutations Linked to AML
Researchers have identified multiple genes that play a role in the development of AML. Each one contributes in different ways to how the disease behaves and how it responds to treatment.
Some of the most significant include:
- FLT3 mutation: Found in roughly one-third of AML patients, this mutation causes rapid cell growth and can make the disease more aggressive.
- NPM1 mutation: A common mutation that affects how cells mature. When present alone, it often indicates a better treatment response.
- IDH1 and IDH2 mutations: These alter cell metabolism, leading to abnormal cell division and energy use.
- RUNX1, TP53, and CEBPA mutations: These impact how blood cells form and differentiate, directly contributing to leukemia development.
Modern genetic testing now allows doctors to identify these mutations in individual patients, providing insight into both the cause and best treatment strategy for each case.
Environmental and Lifestyle Factors
While genetic changes are at the core of AML, several external factors increase the risk of those mutations forming over time.
1. Exposure to Benzene
Benzene is one of the most well-established risk factors for leukemia. It’s a chemical found in industrial solvents, fuel, and cigarette smoke. Workers in manufacturing, petrochemical, or transportation industries may face higher exposure if safety precautions aren’t followed.
Long-term exposure damages bone marrow DNA, which can eventually lead to leukemia. Strict workplace safety standards have greatly reduced this risk in the U.S., but occasional cases still occur among individuals exposed over many years.
2. Tobacco Smoke
Cigarette smoke contains benzene and dozens of other chemicals that affect DNA stability. Smoking has been linked to an increased risk of AML, especially in older adults. The good news: risk decreases significantly after quitting.
3. Previous Cancer Treatment
People who have undergone chemotherapy or radiation therapy for other cancers may later develop AML. This is known as therapy-related AML, or t-AML.
Certain chemotherapy drugs — including alkylating agents and topoisomerase II inhibitors — can cause DNA damage to bone marrow cells years after treatment. Patients who receive both chemotherapy and radiation are at slightly higher risk.
4. Radiation Exposure
High-dose radiation, such as from nuclear accidents or intense radiation therapy, can damage DNA and raise leukemia risk. Everyday diagnostic imaging (like X-rays or CT scans), however, does not significantly contribute to AML development.
5. Occupational and Environmental Hazards
People working in industries involving oil refining, painting, or rubber production may face elevated risk if exposed to carcinogenic chemicals over long periods. Continuous monitoring and protective measures are critical in such environments.
Medical and Genetic Conditions Linked to AML
Several health conditions can make a person more susceptible to AML. These are not causes by themselves but can increase vulnerability to cellular changes that lead to leukemia.
- Myelodysplastic syndromes (MDS): A group of bone marrow disorders that can evolve into AML over time.
- Aplastic anemia: A rare condition where the bone marrow stops producing enough blood cells.
- Down syndrome and other inherited syndromes: People with genetic conditions like Down syndrome, Fanconi anemia, or Bloom syndrome have a higher lifetime risk of developing AML.
These factors highlight how AML can sometimes be a secondary development — emerging after years of existing bone marrow dysfunction.
Age and Gender Patterns
Age remains one of the strongest predictors for AML. Most cases occur in adults over 60, and the risk rises as the body accumulates genetic mutations with age. Men are diagnosed slightly more often than women, though scientists are still studying why this difference exists.
Some research suggests that hormonal differences and occupational exposures may contribute to the gender gap, but there’s no single clear explanation yet.
Is AML Hereditary?
Most AML cases are not inherited. The mutations that cause it typically develop during a person’s lifetime. However, certain inherited genetic conditions can increase risk, and families with a history of blood cancers may carry mutations that predispose them to leukemia.
Genetic counseling can help identify individuals with higher inherited risk. Testing can also help doctors create personalized screening plans to detect any early bone marrow changes before they become cancerous.
New Scientific Insights in 2025
Recent breakthroughs have changed how doctors understand and treat AML. As of 2025, researchers are focusing on precision medicine — the idea that treatment should be based on each patient’s unique genetic makeup.
Here are some of the most promising areas of progress:
- Targeted therapies: Medications that specifically block the activity of mutated genes like FLT3 or IDH1/2 are now widely used and improving outcomes.
- Epigenetic research: Scientists are studying how external factors, such as toxins or diet, can change how genes are expressed without altering DNA. This could help explain how environmental exposure triggers leukemia in genetically susceptible individuals.
- Immunotherapy: Treatments that strengthen the immune system’s ability to recognize and destroy leukemia cells are showing early success.
- Stem cell advancements: Improved stem cell transplant techniques are helping more AML patients achieve long-term remission.
These developments represent a major step forward in understanding not just how AML starts but how it can be effectively controlled or cured.
Reducing Risk in Everyday Life
While not all cases of AML can be prevented, awareness of risk factors helps lower the odds. Steps to reduce risk include:
- Avoid smoking or exposure to secondhand smoke.
- Follow all safety regulations when working with industrial chemicals.
- Limit unnecessary exposure to radiation.
- Maintain a healthy lifestyle to support immune and bone marrow health.
- Regularly monitor blood counts if you’ve had prior chemotherapy or bone marrow disorders.
Doctors also emphasize that early detection is critical. Symptoms such as fatigue, easy bruising, frequent infections, or unexplained bleeding should never be ignored — prompt medical evaluation can make a life-saving difference.
Hope for the Future
The outlook for AML has improved dramatically in recent years. With better diagnostics and more personalized treatments, survival rates are higher than ever. Scientists continue to uncover new genetic insights that could one day allow doctors to prevent leukemia before it begins.
Today’s research is focused not only on treating AML but understanding its root causes — bridging the gap between genetics, environment, and individual biology. The knowledge gained will help guide prevention strategies and make therapies safer and more effective for future generations.
Understanding the origins of acute myeloid leukemia is key to saving lives — and every new discovery brings us closer to stopping this disease before it starts. Stay informed, share awareness, and help others recognize the importance of early action.