Symptoms of leukemia

The signs or symptoms of leukemia may vary depending on whether you have an acute or chronic type of leukemia.

Acute leukemia may cause signs and symptoms that are similar to the flu. They come on suddenly within days or weeks.

Chronic leukemia often causes only a few symptoms or none at all. Signs and symptoms usually develop gradually. People with a chronic leukemia often complain that they just do not feel well. The disease is often found during a routine blood test.

Other health conditions can cause the same symptoms as leukemia. See your doctor if you have:

  • fatigue
  • a general feeling of discomfort or illness (called malaise)
  • loss of appetite
  • weight loss
  • fever
  • shortness of breath
  • paleness
  • rapid heartbeat (called palpitations)
  • weakness
  • dizziness
  • easy bruising
  • frequent or severe nose bleeds
  • bleeding gums
  • bleeding in the middle of a menstrual cycle or heavy menstrual flow
  • tiny, flat, red spots caused by bleeding just under the surface of the skin (called petechiae)
  • frequent infections in the lungs, urinary tract or gums or around the anus
  • frequent cold sores
  • vomiting
  • headache
  • sore throat
  • night sweats
  • bone or joint pain
  • enlarged lymph nodes in the neck, underarm, groin or above the collarbone
  • abdominal discomfort or feeling of fullness
  • vision problems
  • sores in the eyes
  • swelling of the testicles
  • chloroma – a collection of leukemia cells, or blasts, under the skin or in other parts of the body
  • leukemia cutis – appears as sores or as patches of any size that are usually pink or tan in colour
  • leukocytoclastic vasculitis – a condition that looks like an allergic reaction on the skin and usually causes sores on the hands and feet
  • Sweet’s syndrome, or acute febrile neutrophilic dermatosis – causes fever and painful sores that may appear anywhere on the body

Cancer-related emergencies

In some cases, leukemia or its treatments can cause serious problems. These cancer-related emergencies need to be treated right away.

Tumour lysis syndrome can occur when chemotherapy is given to treat acute leukemia, but the cancer cells die quickly and the kidneys can’t remove the substances they release from the blood fast enough. Find out more about tumour lysis syndrome.

Superior vena cava syndrome (SVCS) may occur when too many leukemia cells develop in the thymus, causing it to get bigger and block the windpipe. SVCS may develop with acute lymphoblastic leukemia (ALL). Find out more about superior vena cava syndrome.

Disseminated intravascular coagulation (DIC) is a condition where blood clots develop in the bloodstream and bleeding also occurs. DIC can develop more often with acute promyelocytic leukemia, but also with other subtypes of acute myeloid leukemia (AML). Find out more about disseminated intravascular coagulation.

Expert review and references

  • American Cancer Society. Leukemia - Acute Lymphocytic (Adults). Atlanta, GA: American Cancer Society; 2013.
  • American Cancer Society. Leukemia - Acute Myeloid (Myelogenous). Atlanta, GA: American Cancer Society; 2013: https://www.cancer.org/.
  • American Cancer Society. Leukemia - Chronic Lymphocytic. Atlanta, GA: American Cancer Society; 2013: https://www.cancer.org/.
  • American Cancer Society. Leukemia - Chronic Myeloid (Myelogenous). Atlanta, GA: 2013: https://www.cancer.org/.
  • Borthakur G, O'Brien S . Treatment of chronic lymphocytic leukemia and related disorders. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 9: pp. 121-119.
  • Goekbuget N, Hoelzer D . Diagnosis and Treatment of adult acute lymphoblastic leukemia. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 20: pp. 331-354.
  • Kurtin SE . Leukemia and myelodysplastic syndromes. Yarbro, CH, Wujcki D, & Holmes Gobel B. (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 57: pp. 1369-1398.
  • O'Brien SG, Goldman JM . Diagnosis and treatment of chronic myeloid leukemia. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 5: pp. 45-62.
  • Wiernik PH . Diagnosis and treatment of adult acute myeloid leukemia other than acute promyelocytic leukemia. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 22: pp. 375-401.

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