Early symptoms of leukemia often resemble the flu or other common illnesses. It’s important to talk with your doctor if you notice unusual symptoms.
A hematologist-oncologist can diagnose leukemia with blood and bone marrow tests. They may also test for cancer in other organs and tissues using imaging and other tests.
Swollen lymph nodes
Swollen lymph nodes, or glands, are one of the most common signs of leukemia. Lymph nodes are small, round structures that play a critical role in the immune system. They protect the body from infection by trapping harmful bacteria, viruses and waste in their fluid. When an infection is present, swollen lymph nodes alert the immune system to the danger and grow larger to contain the intruders.
Swelling of the lymph nodes can occur in a single area or throughout the body. Often, the swollen lymph nodes are painful to the touch and feel hard or fixed in place. They may also be very warm, red or swollen and tender. If the swollen lymph nodes are very enlarged, painful and move when touched or pushed on, they may be a sign of cancer.
Doctors can usually determine the cause of swollen lymph nodes by performing a physical examination and asking questions about the person’s symptoms and medical history. They will also conduct blood tests and imaging tests to examine the lymph nodes and the areas around them.
The blood tests will let the doctor know whether the levels of red and white blood cells, platelets and lymphocytes are within a normal range. Leukemia is a group of diseases that affects the bone marrow, where healthy blood cells are produced. The disease can cause too many abnormal white blood cells to form, which can’t fight infections or carry out other vital functions.
Swollen lymph nodes can also be caused by a variety of other conditions, including infectious conditions such as bacterial infections or viral infections like the flu or cold. Some autoimmune and immunologic conditions, such as lupus and rheumatoid arthritis can also lead to swollen lymph nodes. Cancers that have spread to the lymph nodes from other parts of the body are another common cause.
Bruises
People with leukemia may bruise more easily, and a new or unexplained bruise that doesn’t seem to have a clear cause can be a warning sign. The underlying cancer cells crowd out other blood cells that help the body form clots and prevent bleeding, so if you get a bruise or see multiple unexplained bruises, talk to your doctor right away.
A bruise is caused when the delicate vessels that circulate blood in the skin are damaged or broken. The blood collects under the skin, causing it to appear reddish or bluish in color at first (red for oxygenated blood coming from the lungs; blue for carbon dioxide-rich blood going back to the lungs). Over time, the bruise turns yellow, brown and light green before finally fading.
When you have leukemia, the lack of platelets means that your body can’t clot properly and it’s harder to stop small injuries from bleeding, including tiny cuts or scrapes that wouldn’t normally leave a mark. This can also lead to a condition called petechiae, which are small, red or purple spots on the skin that look like bruises but don’t ache or hurt. Petechiae can be a sign of poor clotting and leukemia, especially in children.
Another possible symptom of leukemia is a rash called leukemia cutis, which appears as discolored patches or bumps on the skin. It occurs when leukemia cells enter the skin and the immune system becomes overwhelmed. A rash is often treated with chemotherapy or other medicines used to treat the underlying leukemia, but if you don’t know the cause of your rash, it’s important to let your doctor know right away. A rash could indicate a fungal infection, such as candida or a viral illness, and you may need to take antibiotics.
Fatigue
The cancer cells in leukemia (loo-KEE-mă) crowd out or suppress the growth of normal blood and bone marrow cells. As a result, the body can’t make enough healthy red blood cells, white blood cells, or platelets. This leads to tiredness. There are many different types of leukemia. Each type starts in a different cell in the bone marrow (spongy tissue inside the bones). The type of leukemia you have determines how fast your fatigue gets worse and how often it happens.
Fatigue may also be caused by other health conditions or lifestyle habits. If you’re feeling very tired, talk to your doctor about it. They might recommend getting more sleep or changing your lifestyle habits.
Several kinds of blood tests can help your doctor find out what’s causing your fatigue. A complete blood count (CBC) shows whether you have too few or too many healthy red blood cells, white blood cells, and platelets. It also checks your liver and kidney function, and if you have iron deficiency or anemia.
A biopsy of your bone marrow (bo-MAY-tum) checks for cancer cells and changes in the marrow. Your doctor will give you numbing medicine before they use a needle to remove a small amount of marrow from the space between two bones in your lower back. Then they’ll send it to the lab for testing.
A bone marrow biopsy can show whether you have leukemia or another condition that causes fatigue, such as rheumatoid arthritis, fibromyalgia, or thyroid disease. It can also tell your doctor if the leukemia is acute or chronic. If it’s chronic, it will grow slowly and you might not notice any symptoms for years. If it’s acute, the cancer will grow faster and you’ll need treatment right away.
Loss of appetite
A loss of appetite can be a sign of leukemia, especially when it’s one of the first symptoms you notice. This is because leukemia affects the blood and bone marrow (the spongy tissue inside bones where blood cells are made). When cancerous white blood cells crowd out healthy ones, there’s less room for red blood cells that carry oxygen and platelets that help your body clot. This can lead to problems like low blood pressure, a general feeling of being unwell and, in some cases, weight loss.
Symptoms of leukemia can vary depending on the type. For example, chronic lymphocytic leukemia (CLL) is a type of cancer that starts in lymphocytes, a type of white blood cell that helps fight infection. This type of leukemia usually happens in older adults and isn’t as fast-growing as other types of leukemia. Acute myeloid leukemia (AML) is another form of the disease that’s more serious and happens faster. This type of leukemia can progress to a stage called leukostasis or blast crisis, which is an emergency and needs immediate treatment. It can cause breathing problems, changes to vision and confusion, as well as vomiting or a lack of muscle control.
Most early signs of leukemia can be mistaken for other conditions, which is why it’s important to keep an eye on your symptoms and go to your doctor if you’re worried. They’ll want to run tests to see if you have leukemia or any other health condition. These include a complete blood count (CBC), which checks your levels of white blood cells, red blood cells and platelets. They may also do a spinal tap, which involves making your skin numb and inserting a needle into the space between two of your lower back bones to get a sample of fluid from there. Imaging tests, such as CT scans or MRIs, can show if leukemia has spread to other parts of your body.
Pain
Unexpected bone or joint pain is a possible leukemia symptom. Abnormal white blood cells can build up near or inside bones, causing pain in the long bones of the arms and legs, as well as the ribs and the chest (sternum). The pain may range from mild to severe and usually gets worse over time. Bone pain can also occur when leukemia cells build up in the spleen or liver, which then becomes enlarged. In some cases, the enlarged spleen can press on the windpipe or cause feelings of fullness in the abdomen.
The cancerous blood cells in some types of leukemia can destroy platelets, which are responsible for clotting the blood and stopping bleeding. This condition is called thrombocytopenia. This can result in nosebleeds, easy bruising and heavy menstrual bleeding. The symptoms of this complication may appear late in the disease and could be mistaken for a cold or flu.
As the leukemia cells multiply, they can crowd out the normal blood cells. This can lead to low red blood cell counts, which can cause anemia. Anemia can cause fatigue, weakness and breathlessness.
Some people with chronic forms of leukemia don’t experience any symptoms at all, especially if the disease isn’t very aggressive. They might find out they have the disease only after a routine blood test shows lower-than-normal blood counts and their doctor decides to investigate further. In addition to blood tests, doctors might use imaging and other diagnostic procedures such as a bone scan or lumbar puncture (spinal tap) to see whether the leukemia has spread to other organs or tissues. If these signs and symptoms are present, Rocky Mountain Cancer Centers recommends making an appointment with your physician immediately.
