Many people first notice something is off when fatigue doesn’t match their activity, bruises appear easily, or nosebleeds and gum bleeding happen more than usual. Fevers, frequent infections, or night sweats can follow, and some develop bone pain, shortness of breath, or a feeling of fullness under the ribs from an enlarged spleen. Blood tests done for these symptoms often reveal low red cells, platelets, or abnormal white cells, which prompts urgent evaluation for acute myeloblastic leukemia with maturation.