Leukemia Warning Signs and Symptoms

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Overview - Prior to Any Signs or Symptoms

Leukemia starts in the bone marrow, where white blood cells are produced and where all of the blood-forming cells reside. In leukemia, there is an overproduction of white blood cells that are abnormal or “stuck” in an early stage of development. These leukemia cells may not be able to do the job of the healthy, mature white blood cells. In addition, their presence in the bone marrow in some cases crowds out and prevents normal blood-forming cells to do their jobs.

Both the production of these abnormal cells and the effect of crowding out of the normal tissue contribute to the signs and symptoms of leukemia.

There are two types of main categories of leukemia: acute and chronic. These categories are further divided to give you the four basic different types of leukemia: two acute leukemias (ALL and AML) and two chronic leukemias (CLL and CML).

  • When acute leukemia is diagnosed, usually there are already a large number of rapidly growing leukemia cells present. Signs and symptoms may have been present for less than three months or even just a few days.
  • On the other hand, chronic leukemia develops more slowly and produces cells that tend to function more normally in doing their jobs than the immature cells of acute leukemia.  As such, the signs and symptoms of chronic leukemia may may be absent at first, or may take years to develop. In fact, many cases of chronic leukemia are found by chance during routine check-ups.

    Signs and Symptoms

    The most common symptoms of leukemia are vague and non-specific. As a result, they are often explained away by the patient as “coming down with something” or getting “run down.” Cases of acute and chronic leukemia can produce very different initial symptoms, as well. The most common symptoms of leukemia (both acute and chronic, combined) include the following:

    • Feeling Weak, Tired or Generally Unwell. In most cases, this is caused by a decreased number of red blood cells in the bloodstream or anemia. This prevents adequate oxygen being transported to your tissues and muscles, leaving your body feeling fatigued and weak.
    • Frequent Infections. Leukemia cells may not be able to adequately help your body fight off infection. What is more, the leukemia can crowd out other cells in the bone marrow, preventing the body from ensuring an adequate supply of white blood cells. As a result, people affected by leukemia are very prone to developing infections. Common sites of infection include the mouth and throat, skin, lungs, urinary tract or bladder, or the area around the anus.
    • Unexplained Fevers. In some cases, leukemia cells can cause your body to release chemicals that stimulate your brain to raise your body temperature. Fevers can also be caused by an infection.
    • Abnormal Bruising or Excessive Bleeding. Leukemia cells causing crowding in the bone marrow prevent the production of red blood cells white blood cells and platelets. The platelets are fragments of cells that clump together and stop or slow bleeding when an injury occurs to a blood vessel. When there are insufficient platelets, called thrombocytopenia, bleeding may occur in the form of nosebleeds, heavy menstrual bleeding, bleeding gums, bruises and tiny red spots under the skin called petechiae (pet-eek-ee-eye).
    • Bone and Joint Pain. Bone and joint pain are most common in areas where there is a large amount of bone marrow, such as the pelvis (hips) or breastbone (sternum). This is caused by the crowding of the marrow with excessive numbers of abnormal white blood cells.
    • Enlarged Lymph Nodes. Sometimes, leukemia cells can accumulate in the lymph nodes and cause them to become swollen and tender.
    • Abdominal Discomfort. Abnormal white blood cells can also collect in the liver and spleen causing your abdomen to swell and become uncomfortable. This type of swelling can also decrease your appetite, or make you feel full early.
    • Headaches and Other Neurological Complaints. Headaches and other neurologic symptoms such as seizures, dizziness, visual changes and nausea and vomiting may occur when leukemia cells invade the fluid surrounding your brain and spinal cord, or cerebrospinal fluid. This type of central nervous system involvement is most common in acute lymphocytic leukemia (ALL).

    A Word From Verywell

    Leukemia cannot be diagnosed based on the presence of signs and symptoms alone. There are a number of tests and procedures that must be completed to confirm a suspected case of leukemia. It is very important to note that these signs and symptoms can also be caused by many other, non-cancerous conditions. If you are worried about any symptoms you are experiencing, you should always seek assistance from a qualified healthcare provider.


    Caldwell, B.(2007). Acute leukemias. In Ciesla, B. (Ed.)Hematology in Practice (pp. 159-185). Philadelphia, Pennsylvania: F.A. Davis Company.

    Finnegan, K.(2007). Chronic myeloproliferative disorders. In Ciesla, B. (Ed.) Hematology in Practice (pp.187-203). Philadelphia, Pennsylvania: F.A. Davis Company.

    Wujcik, D. Leukemia. In Yarbro, C., Frogge, M., Goodman, M. and Groenwald, S. eds (2000). Cancer Nursing: Principles and Practice 5th ed Jones and Bartlett: Sudbury: MA (pp. 1244-1269).

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