What Craig Sager's Story Can Teach Us About Acute Myeloid Leukemia

What he and his family made public

Craig Sager was diagnosed with acute myeloid leukemia on April 10, 2014. CNN reported that he received three bone marrow transplants, all with his son Craig Sager Jr. as the donor: one after the initial diagnosis, a second in March 2015 when the disease returned, and a third on August 31, 2016. CNN noted that having three transplants is extremely rare.

He was away from the sidelines for 11 months and returned to work, covering games while in active treatment. He died in December 2016, days after being inducted into the Sports Broadcasting Hall of Fame. He was 65.

Those are the facts he and his family chose to share. This article does not go beyond them, and it draws no conclusions about his care. What follows is about the disease.

What acute myeloid leukemia is

Bone marrow, the spongy tissue inside bones, manufactures blood cells. Myeloid cells are one of its two main production lines, and they give rise to red blood cells, platelets, and most white blood cells.

In acute myeloid leukemia, immature myeloid cells called blasts multiply out of control and fill the marrow. They crowd out normal production. The result is too few red cells to carry oxygen, too few platelets to control bleeding, and too few functioning white cells to fight infection.

The word "acute" is doing real work. NCI notes that symptoms typically develop over just four to six weeks before diagnosis. This is not a disease that waits.

The American Cancer Society now projects 22,720 new cases and 11,500 deaths in the United States for 2026, the pair SEER carries; the 22,010 and 11,090 printed as reference 1 in NCI's PDQ summary are the 2025 estimate. SEER, the federal statistics program, puts the median age at diagnosis at 70 and the median age at death at 74, with about 1.1 percent of all new cancer diagnoses falling into this category.

How it announces itself

NCI's list of early signs is short, and every item on it sounds like something else:

• Weakness, or feeling tired.
• Fever.
• Infection.
• Paleness, or loss of normal skin color.
• Bleeding.

That bleeding is worth unpacking, because low platelets show up in specific ways. People notice bruises appearing without injury, gums that bleed when brushing, nosebleeds that will not stop, or tiny red or purple pinpoint spots on the skin.

When to get checked

The realistic advice is not to memorize a symptom list but to notice a pattern building over weeks. Seek care promptly for any of these:

• Fatigue that has worsened steadily over several weeks and is not explained by sleep or workload.
• Fever with no clear source, particularly with drenching night sweats.
• Bruises appearing without injury, or bruises much larger than the knock that caused them.
• Bleeding gums, repeated nosebleeds, or a cut that keeps oozing.
• Pinpoint red or purple spots on the skin, often on the lower legs.
• Infections that come back one after another, or an infection that will not clear on antibiotics.
• Unusual paleness, breathlessness on mild exertion, or a racing heart at rest.

There is no screening test for leukemia in people without symptoms, and NCI has no evidence-based screening summary for it. The entry point is a complete blood count, an inexpensive and routine test that can be run the same day.

Known risk factors include being male, older age, smoking, prior chemotherapy or radiation therapy, exposure to environmental radiation or to the chemical benzene, and certain inherited or blood disorders.

The tests that settle it

A complete blood count usually raises the suspicion. A blood smear, in which a drop of blood is examined under a microscope, may already show blasts.

Confirmation comes from the marrow. Bone marrow aspiration and biopsy takes a sample through a needle placed in the hipbone or breastbone. NCI's threshold for diagnosis is 20 percent or more blasts in marrow or blood, with exceptions for certain chromosome abnormalities that establish the diagnosis at lower counts.

The sample then goes for a battery of tests that shape treatment. Flow cytometry and immunophenotyping read the markers on the cell surface. Cytogenetic analysis looks at chromosomes. Molecular testing hunts for changes in genes including NPM1, FLT3, CEBPA, and RUNX1. These findings sort patients into risk groups and influence whether a transplant is recommended.

Treatment comes in phases

NCI describes two phases. Remission induction therapy comes first, and its aim is to clear leukemia cells and restore normal blood counts. The standard regimen combines cytarabine with an anthracycline chemotherapy drug. Roughly 60 to 70 percent of adults reach complete remission after induction.

Consolidation therapy follows. Its purpose is to destroy the leukemia cells that survived but are not detectable, which are the cells that cause relapse. High-dose cytarabine is a common choice.

What a transplant actually does

A stem cell transplant restores blood stem cells destroyed by high-dose chemotherapy or radiation. An autologous transplant uses a person's own cells. An allogeneic transplant uses a donor's, and requires close matching.

In leukemia specifically, NCI says the transplant may work against the cancer directly, through an effect called graft-versus-tumor, in which donor white blood cells attack surviving leukemia cells.

The same immune power carries a cost. Graft-versus-host disease occurs when donor white cells treat the recipient's own tissue as foreign and attack it, most often the skin, liver, and intestines. NCI classifies it as acute within three months and chronic beyond that. Other risks include infertility, cataracts, second cancers, and damage to the liver, kidneys, lungs, or heart. Blood counts recover in weeks, but immune recovery after an allogeneic transplant takes one to two years.

Reading the numbers

SEER reports that 33.4 percent of people diagnosed with acute myeloid leukemia between 2016 and 2022 survived five years or longer. NCI notes that more than 25 percent of adults with the disease can be expected to survive three years or more.

Those figures pool every subtype, every risk group, and every age. A person of 30 with favorable genetics and a person of 78 with adverse markers sit inside the same percentage, and it fits neither of them well. Group statistics set context. They do not describe any individual reader.

Sources

• https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq
• https://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq
• https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant
• https://seer.cancer.gov/statfacts/html/amyl.html
• https://www.cnn.com/2016/12/15/us/craig-sager-dies
• https://www.cancer.org/research/cancer-facts-statistics.html