What are the symptoms of leukemia?

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Leukemia symptoms may vary according to the person’s age, as well as the type of leukemia and stage of the disease.

Childhood leukemia

Recognizing the signs of leukemia in a child can be difficult. A child may not be able to describe their symptoms as easily as an adult could.

Some of the most common signs and symptoms of childhood leukemia include:

• loss of appetite
• bleeding gums
• bone pain
• dizziness
• easily bleeding
• easily bruising
• fever without other signs of infection
• frequent coughing
• frequent infections that seem to take longer to go away or infections that keep coming back
• joint pain
• problems breathing
• rashes
• swollen lymph nodes that the person may feel under the arms, above the collarbone, or in the groin
• unexplained fatigue
• unintentional weight loss

Many of these symptoms can resemble those of other childhood illnesses, such as the flu, respiratory syncytial virus, or pneumonia.

Adult symptoms

The symptoms of leukemia in adults can range from general feelings of being unwell to abdominal swelling due to problems with the spleen — an immune system organ.

A person may experience the following symptoms.

1. Nonspecific symptoms

Sometimes, a person can experience flu-like symptoms that they would not necessarily associate with leukemia. These symptoms are usually due to the destruction of blood cells in the body and the increased amount of energy that the body needs to fight off the disease.

Symptoms include:

• loss of appetite
• fever
• night sweats
• unexplained weight loss

A person may often relate these symptoms to their leukemia once a doctor diagnoses them.

2. Abdominal swelling

As leukemia cells multiply, they may start to build up in the spleen and the liver. The presence of excess cells can cause these organs to enlarge. As a result, a person may experience feelings of abdominal fullness or swelling.

3. Bleeding problems

Some types of leukemia can destroy platelets, a blood cell type responsible for helping stop bleeding. As a result, a person may notice that they bleed more easily if they have a cut. They may also have bleeding gums or frequent nosebleeds.

4. Bone or joint pain

Abnormal cells can build up near or inside bones, which can cause unexplained bone or joint pain. This pain can range from a dull ache to severe pain and discomfort.

5. Increased incidence of infections

Leukemia can destroy the white blood cells that help fight off infections. As a result, people with the condition can experience higher rates of infection and fever due to low white blood cell counts.

A person may feel as though they are always sick and fighting off various viral and bacterial illnesses. They may also have a low grade fever.

6. Lymph node enlargement

Lymph nodes are a key aspect of the body’s immune system as they filter fluid and potentially harmful substances from the body. If leukemia cells spread and multiply, they may reach lymph nodes in the body.

A person or doctor may be able to feel the lymph nodes as fluid-filled lumps under the skin.

Common locations where lymph node enlargement may occur include:

• either side of the groin
• the sides of the neck
• under the arms

Sometimes, the lymph node swelling is not to a degree where a person can feel the swollen nodes.

7. Superior vena cava (SVC) syndrome

Some people have a form of leukemia that affects T cells in the thymus. The thymus is a gland near the trachea, or windpipe, that acts as an immune and endocrine system organ.

If leukemia cells are present in the thymus, the gland can start to swell and place pressure on the SVC. This large vein transports blood to the heart from the upper body.

The pressure from the thymus on the SVC can cause blood to back up in the veins, which can lead to dizziness, headaches, and swelling of the chest, arms, face, and neck. Some people may even experience changes in thinking and consciousness because of affected blood flow from the vein.

SVC syndrome is a serious medical complication of leukemia that requires immediate medical treatment.

Leukemia does not always cause symptoms in the early stages. Often, the initial symptoms closely resemble those of the flu, but unlike flu symptoms, they then do not go away.

Examples of common early leukemia symptoms include:

• loss of appetite
• bone pain
• easily bruising
• fatigue
• fever
• frequent infections
• headaches
• heavy bleeding
• joint pain
• night sweats
• shortness of breath

If a person’s symptoms do not go away over a few weeks, they should talk to their doctor.

Doctors may classify leukemia as either acute or chronic. Acute leukemia comes on suddenly, and the cancerous cells multiply rapidly. Chronic conditions result from slowly developing cancer cells, and it may take years before a person experiences any symptoms.

However, acute and chronic leukemia have some similarities. They both cause flu-like symptoms, fatigue, and general feelings of being unwell.

Examples of chronic leukemia symptoms include:

• anemia
• loss of appetite
• discomfort or a feeling of fullness in the upper abdomen on the left side (where the spleen sits)
• easily bruising or bleeding
• easily becoming fatigued
• enlarged lymph nodes that are not painful to the touch
• fever
• night sweats
• weight loss

Acute leukemia symptoms may include:

• bone aches
• cuts that are slow to heal
• fatigue that does not improve with rest
• infections that will not go away
• joint aches
• low grade fever
• night sweats
• pale skin
• small red dots underneath the skin that doctors call petechiae

These are just some examples of acute and chronic leukemia symptoms. A person may experience other symptoms instead or in addition.

A person should see their doctor if they experience the following symptoms, which may be due to leukemia:

• loss of appetite
• a low grade fever that does not go away
• frequent and prolonged infections
• unexplained fatigue
• unexplained weight loss

If a person has other symptoms that represent changes to their medical history and affect their well-being, they should talk to their doctor.

Doctors have not identified one single underlying cause of leukemia. Instead, they think that multiple factors can affect the likelihood of a person getting the disease. These factors include:

• older age
• having a close relative, such as a parent or sibling, who had leukemia
• history of chemotherapy or radiation for other cancer treatments
• history of cigarette smoking
• history of exposure to chemicals, such as Agent Orange or benzene
• history of exposure to high radiation levels

However, just because a person has these risk factors, it does not mean that they will get leukemia.

Doctors usually diagnose leukemia using a combination of blood tests to determine the average levels of certain blood cells. A doctor may also take a bone marrow biopsy to identify cancerous cells or the presence of other harmful cells in the body.

The treatment options for leukemia depend on the type of leukemia that a doctor diagnoses the person as having.

Examples of possible treatments include:

• chemotherapy
• immune-modulating drugs
• immunosuppressive therapies
• splenectomy, which is the surgical removal of the spleen
• stem cell transplants

Again, the best treatment will depend on the underlying cause of leukemia, as some types of leukemia respond differently to certain treatment approaches.

Survival rates for people with leukemia vary depending on various factors, including the type of leukemia, the person’s age at diagnosis, and how early a doctor makes the diagnosis.

A person with a diagnosis of leukemia should talk to their doctor about their likely survival rate and how treatments may change their outlook.

Leukemia can cause a variety of symptoms. Initially, a person may dismiss the symptoms as being due to a viral or bacterial illness. Further blood tests may reveal lower-than-expected blood counts and lead a doctor to conduct more diagnostic tests.

If a person suspects that their symptoms could indicate leukemia, they should talk to their doctor.