Leukemia usually starts in the bone marrow, where white blood cells are produced. In Leukemia, there is an overproduction of white blood cells that are abnormal or “stuck” in an early stage of the maturation process. These leukemia cells are non functional and are unable to do the job of healthy, mature blood cells. In addition, their presence in the bone marrow crowds and prevents the ability of other normal blood forming cells to do their jobs. This leads to the signs and symptoms of leukemia.
There are two types of main subdivisions of Leukemia: acute and chronic. These subdivisions are further divided into different types of Leukemias.
When acute leukemia is diagnosed, there are usually already a large and rapidly growing number of leukemia cells. Signs and symptoms may have been present for less than three months or even as little as a few days.
On the other hand, chronic leukemia develops much more slowly and produces cells that are more functional than acute leukemia. As such, the signs and symptoms of chronic leukemia may arise over a very long period of time, or not at all. In fact, many cases of chronic leukemia are found by chance during routine check ups.
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.” The most common symptoms of leukemia include:
- 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 are not only abnormal or too underdeveloped to help your body fight off infection, they also inhibit the ability of the bone marrow to produce healthy 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. The abnormal production of leukemia cells prevents the bone marrow from making adequate numbers of healthy blood cells, such as platelets. 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 or "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 is 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 (CSF). This type of central nervous system (CNS) involvement is most common in acute lymphocytic leukemia (ALL).
The Last Word
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).