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Leukemia is a type of blood cancer in which blood stem cells develop abnormally and excessively in the bone marrow. Leukemia causes symptoms when abnormal white blood cells begin to crowd out healthy blood cells and spread. Leukemia is closely related to other types of blood cancer, such as lymphoma, myeloma, and myeloproliferative neoplasms (MPNs).
Many people experience no symptoms of leukemia when they are first diagnosed. Some symptoms of leukemia can resemble those of a common virus such as a cold or the flu. Leukemia symptoms may change or worsen over time as the cancer progresses.
Some common symptoms of leukemia are also typical side effects of leukemia treatments. Your doctor can help you understand where symptoms are coming from and how best to manage them.
Doctors classify leukemia by the type of white blood cells involved and by whether the cancer progresses quickly (acute leukemia) or more slowly (chronic leukemia). Because of these differences, each type of leukemia can cause different symptoms. The four main types of leukemia are acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), and chronic myeloid leukemia (CML).
Many symptoms of ALL are caused by low levels of healthy blood cells. For instance, anemia (low levels of red blood cells) can cause fatigue, weakness, pale skin, dizziness, and shortness of breath because the tissues of the body are not getting enough oxygen.
Similarly, ALL can also cause thrombocytopenia, or low levels of platelets, the blood cell fragments necessary for blood to clot effectively. Low levels of platelets can lead to ALL symptoms including:
ALL can cause swelling in the lymph nodes or spleen (known as splenomegaly). Splenomegaly may cause abdominal discomfort or a feeling of fullness after only a few bites.
Rarely in ALL, leukemia cells can spread to other parts of the body and cause symptoms. Symptoms of ALL spreading may include:
AML is also known as acute myelogenous leukemia. Similar to ALL, AML can also cause anemia, a low level of red blood cells. Anemia may result in:
Infections are common in people with AML since they often have a shortage of healthy white blood cells, which function in the immune system to fight viruses and bacteria. Abnormal cells cannot fight infection.
Low levels of platelets may result in abnormal bleeding, bruising, and heavy menstrual periods.
AML can cause swelling in the lymph nodes and spleen (splenomegaly). Splenomegaly can cause abdominal discomfort and feeling full early in a meal. AML can also spread to the brain and spinal cord (CNS), testes, kidneys, gums, and skin.
Leukostasis occurs when AML causes high numbers of abnormally large white blood cells called blasts to clog the blood vessels. Rare but dangerous, leukostasis requires emergency medical attention. Symptoms of leukostasis include:
People with CLL/SLL may experience unexplained weight loss, mild fevers, and night sweats. Low levels of red blood cells (known as anemia) can cause fatigue and shortness of breath. Low levels of healthy white blood cells make it harder for the immune system to fight off infections. As a result, people with CLL/SLL may experience infections in the skin, kidneys, and lungs.
Lymph nodes may become enlarged, especially the lymph nodes located in the neck. The spleen may also become swollen, a condition known as splenomegaly. Splenomegaly can cause sensations of abdominal pressure or fullness.
CML is also known as chronic myelogenous leukemia. Symptoms associated with CML are often nonspecific, and it may be unclear what is causing them. Like in other types of leukemia, many symptoms are directly caused by abnormal levels of healthy blood cells.
Other symptoms of CML can include:
Despite the above possible symptoms, the majority of cases of CML are detected by an elevated white cell count in people without any symptoms.
Between 15 percent and 25 percent of those living with cancer are affected by depression. According to the National Institute of Mental Health, the risk factors for depression are higher in people with chronic illnesses. Depression may be triggered by feelings of anxiety, stress, and worry that arise as a result of living with a chronic condition.
There is some evidence that treating depression has benefits for people living with cancer, and may even improve outcomes. Treatments for depression may include antidepressant medication and psychotherapy techniques, such as cognitive behavioral therapy (CBT). Having an active support system, whether family members, friends, a spiritual community, or online or in-person support groups, can make it easier to cope with these challenges.
It can be difficult to tell the difference between symptoms of leukemia and side effects of chemotherapy, radiation therapy, stem cell transplantation, or other treatments used to fight it. Some manifestations are more likely to be side effects of treatment options rather than symptoms directly caused by leukemia. These include:
Symptoms of leukemia and side effects from treatments are likely to be different for each person, depending on many factors. Be sure to report any new or worsening symptoms or side effects to your doctor. Many symptoms and side effects can be managed with medications or lifestyle changes.
Leukemia Condition Guide
Todd Gersten, M.D., is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Learn more about him here. Review provided by VeriMed Healthcare Network.