Leukemia is a cancer of the tissues that make blood, such as bone marrow and the lymphatic system. There are several types of leukemia, and the symptoms you experience will vary depending on the type. Some types are more common in children, while others occur more often in adults.
Symptoms
Leukemia symptoms vary depending on the type of leukemia. But some leukemia symptoms overlap and are common in all forms of the cancer. These include:
Fever
Night sweats
Unexplained weight loss
Fatigue
Loss of appetite
Most of the time, these symptoms result from an illness other than leukemia.
Common signs and symptoms of leukemia include:
Fever
Severe or frequent infections
Unwanted or unintended weight loss
Swelling in the lymph nodes
Enlarged liver or spleen
Finding that you bleed or bruise easily
Having nosebleeds often
Petechiae, or tiny red spots on the skin
Tender or painful bones
All people with acute leukemias will experience some degree of cytopenia, a deficiency in mature blood cells. As abnormal leukemia cells multiply in the bone marrow, they crowd out the cells that usually develop there.
Patients may not have enough healthy red blood cells, a condition called anemia. The following symptoms may be caused by anemia:
Feeling consistently tired or weak
Feeling cold
Dizziness or lightheadedness
Headache
Shortness of breath
A shortage of white blood cells, vital for helping your body fight infections, may result in infections that don’t go away.
Low blood platelet counts are another common sign of leukemia. A shortage of platelets can cause:
Excessive bruising or bleeding
Frequent or severe nosebleeds
Bleeding gums
People with acute forms of the cancer usually notice more symptoms because the disease progresses faster. Those with chronic leukemia may not know they have cancer until they take a routine blood test.
Some symptoms of leukemia are vague, making it challenging to detect.
These are common symptoms of leukemia, but symptoms will vary depending on the type of leukemia.
Types
The symptoms you experience will depend on whether your disease is chronic or acute and the type of blood cells it affects. Acute forms begin rapidly and typically show symptoms like easy bleeding, fever, and fatigue. The cells in acute leukemia are also larger and more aggressive. People with chronic leukemias develop symptoms more slowly, because the affected cells are more mature and don’t impact other organ systems in the same way. Chronic leukemia may present with less-pronounced symptoms.
Acute Lymphocytic Leukemia (ALL)
ALL is most common in children and affects immature white blood cells called lymphoid cells as they develop in the bone marrow.
Most symptoms of acute lymphocytic leukemia (ALL) result from a deficiency of normal blood cells. Problems caused by low blood cell counts include:
Fever
Sweating at night
Appetite loss
Unwanted or unexpected weight loss
Tiredness
Weakness
Dizziness or lightheadedness
Breathlessness
Fever
Infections that repeatedly recur or don’t go away
Easy bruising or bleeding, such as bleeding gums or a heavy menstrual flow in women
Pale skin, although this can be more challenging to identify in people with darker skin tones
If leukemia cells build up in the liver and spleen, you may feel full after only eating a small meal or notice swelling in your belly.
Sometimes, leukemia can cause bone or joint pain from the cells growing in the bone marrow.
If ALL spreads to other places in your body, you may experience symptoms such as:
Enlarged lymph nodes if the cancer spreads to the lymph nodes
Headaches, weakness, seizures, vomiting, facial numbness, blurred vision, or balance issues if the cancer spreads to your brain or spinal cord
Fluid buildup and breathing difficulties if the cancer spreads to your chest
A subtype of ALL can affect the thymus, a small organ in the middle of your chest. An enlarged thymus can cause coughing or trouble breathing. It can also press on the superior vena cava (SVC), a large vein. If this occurs, blood can back up in the veins, leading to a severe condition called SVC syndrome that can lead to the following:
Swelling of the face, neck, arms, and chest
Headaches
Dizziness
Altered consciousness
Acute Myeloid Leukemia (AML)
AML is one of the most common leukemias in adults. Usually, it begins in early cell forms that go on to become white blood cells called myeloid cells. Generally, AML progresses rapidly and requires immediate treatment.
If the acute myeloid leukemia (AML) cancer cells, called blasts, become very high in number, they can cause a serious condition known as leukostasis, which literally means slowing of the normal blood flow due to congestion. This can lead to symptoms such as:
Headache
Slurred speech
Weakness on one side of the body
Confusion
Sleepiness
Shortness of breath
Blurry vision or loss of vision
Some people with AML may have bone or joint pain if the leukemia builds up in the bone marrow in these areas.
If AML spreads to the skin, it can cause spots that look like a rash. Certain types of AML may affect the gums, causing pain, swelling, and bleeding. Enlarged lumps under the skin of the neck, groin, underarms, or collarbone are a sign that the cancer has spread to your lymph nodes.
When cancer cells build up in the liver or spleen, the organs may enlarge, causing abdominal swelling or a sense of fullness.
People with a certain type of AML, known as acute promyelocytic leukemia (APL), may experience bleeding and clotting problems.
AML can spread to your brain or spinal cord. This could cause:
Weakness
Headaches
Vomiting
Seizures
Balance problems
Blurred vision
Numbness in the face
Chronic Lymphocytic Leukemia (CLL)
People with chronic lymphocytic leukemia (CLL) may not have any symptoms when the cancer is diagnosed. Over time, they may gradually notice certain issues.
Anemia can affect someone with CLL, leading to weakness, tiredness, and shortness of breath. But people with CLL often have vague symptoms that other conditions can cause.
CLL affects B lymphocyte cells, which typically help fight infections. People with CLL may also have a high or low white blood cell count. Because their bone marrow is producing too many abnormal blood cells, they don’t have enough healthy cells. As a result, they may experience recurrent infections that don’t resolve on their own.
Bruising, bleeding, frequent nosebleeds, and bleeding gums may occur when you have a shortage of platelets in your blood.
If CLL affects your liver or spleen, you may feel fullness after only a small meal or experience belly pain or swelling. Swollen lymph nodes are another possible sign of CLL.
Chronic Myeloid Leukemia (CML)
If symptoms develop, people with chronic myeloid leukemia (CML) often experience many of the same symptoms as those with CLL. But most people with CML don’t have symptoms at the point of diagnosis. Doctors often identify it during blood tests for other health problems.
The most common sign of CML is an abnormal white blood cell count on blood tests. Very high or low white blood cell counts can lead to frequent infections that are hard to fight off.
But some people with CML may report bone or joint pain if leukemia cells spread from the marrow to the surface of the bone or joint.
Complications
The complications of leukemia generally contribute to its active symptoms, including:
Anemia: Not enough red blood cells means that the blood might not deliver enough oxygen to tissues around the body.
Low white blood cell count: Not having enough healthy white blood cells means the body can struggle to counter infections.
Thrombocytopenia: A low platelet count can reduce the blood’s ability to clot.
Leukemia cells may also spread to other organs, such as the following:
Liver
Spleen
Lymph nodes
Testes
Brain
Treating these complications is vital for preserving quality of life with leukemia. For example, people may need blood transfusions to manage anemia or antibiotics to treat recurrent infections due to low white blood cell count. Platelet transfusions may help to reduce bleeding.
The Takeaway
Leukemia symptoms can vary by type, but common signs include recurrent infections, fatigue, unexplained weight loss, and easy bruising or bleeding.
Symptoms can change depending on the spread of the cancer or its effects on different types of blood cells.
People with chronic forms of leukemia often experience a gradual onset of symptoms, while acute leukemia presents more suddenly and requires immediate medical attention.
Managing leukemia often involves addressing complications like anemia, low white blood cell count, and thrombocytopenia, so consult with a healthcare professional if you experience persistent or severe symptoms.
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Resources
Leukemia - Overview. Mayo Clinic. December 20, 2024.
Thomas Marron, MD, PhD, is the assistant director of early phase and immunotherapy clinical trials at the Tisch Cancer Institute of the Icahn School of Medicine at Mount Sinai in New York City, as well as an assistant professor of medicine in the Icahn School of Medicine. He is a physician scientist working to translate findings from the lab into patient care and treatment. His clinical focus is on early phase clinical trials of cancer vaccines and new immunotherapy combination treatments.
Dr. Marron received his bachelor's degree in human biology from the University of Virginia in Charlottesville in 2005, his PhD in immunology from the Icahn School of Medicine in 2010, and his MD from the Icahn School of Medicine in 2012. He remained at Mount Sinai Hospital for his internal medicine residency, which he completed in 2014, and for his clinical fellowships in hematology and medical oncology, which he completed in 2017.
Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.
Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.
