Different from many other types of cancer, leukemia is not located in a single organ. It is cancer in the blood, and the abnormal cells are not limited to a single tissue. They circulate throughout the body and make the blood thicker, creating a series of problems in many different organs at the same time. Leukemia features an uncontrolled division of stem cells, giving rise to red blood cells, lymphocytes and other types of white blood cells. However, there is excess replication and accelerated circulation of these cells when they are still immature, and they are unable to function correctly.
In leukemia, there are many signs and symptoms and different subtypes of the same disease according to the cell line that is involved in the abnormal replication process. Each one of them has a different course and prognosis, and leukemia can be an acute disease with escalating symptoms that develop in a few days or weeks or chronic, that usually take months or years to develop fully.
The most important signs and symptoms are as follows:
1-Hepatomegaly
It is the clinical name to the enlargement of the liver. This sign is found in the physical exam or through imaging tests, and it is common in various diseases, not only leukemia. Since leukemia features excess immature blood cells, they enter the liver and invade the tissue, increasing the size of the organ.
The same happens to other tissues, especially the spleen, which becomes exaggeratedly large and may even reach the belly button in severe cases. Similarly, leukemia cells may infiltrate in other tissues, which is especially the case in the skin and gums, which is why these patients often have swollen gums and alterations in the skin.
2-Recurrent infections
Depending on which cell line is affected by leukemia, it is highly likely that patients endure more infections than the average population. Acute lymphoblastic leukemia features a reduction in neutrophil count, and these white blood cells are essential to fight off microbial agents. Other types of leukemia reduce the effectiveness of different cell lines, such as lymphocytes, making the body more susceptible to viruses.
Depending on how low the white blood cell count goes, infections become more and more dangerous. Thus, it is important for these patients to pay attention to any sign and symptom of infection before it’s too late, and this is why they are required to take extra measures to prevent infections, such as isolation in the hospital, using mouth covers and other preventive measures.
3-Chronic fatigue
Similar to other types of cancer, leukemia patients experience chronic fatigue as one of the main symptoms. This symptom is more pronounced as the disease progresses and results from the excess energy that is spent to create abnormal blood cells. Additionally, and depending on the type of leukemia, it is highly likely that the patient experiences anemia, a reduction in the red blood cell count. This medical condition leads to a reduction in oxygen supply because red blood cells transport oxygen from the lungs to every tissue in the body. Thus, not enough oxygen is available to create energy, and the patient ends up with low energy levels and chronic fatigue.
4-Fever
Leukemia and fever are closely linked to one another, and finding extreme alterations in blood cell counts along with fever is usually enough to suspect leukemia and start with diagnostic tests to confirm the diagnosis. In some types of leukemia, such as acute lymphoblastic leukemia, fever is the most predominant symptom with no trace of infection in the body. Thus, fever is very common, but it should not be neglected.
Leukemia patients with fever should be careful and attentive to an unusual bout of high temperature because infections give out the same symptoms, and they can be lethal for these patients.
5-Chills
This symptom is closely related to fever because it is a way our body has to increase body temperature. In simple words, inflammatory mediators reach the brain and trigger certain areas that give out the signal of increasing body temperature. To execute the order, the muscles in the body start performing jerking movements similar to what we do when it’s very cold. This is meant to increase body temperature and often felt when the fever reaches its peak. This is another common symptom of leukemia, but should not be neglected as we mentioned when talking about fever.
6-Night sweats
Sometimes, chills and fever are associated with night sweats as well. Leukemia patients may wake up in the middle of the night, drenched in sweat. This often contributes to their sleeping problems, and it may be caused by the disease itself or the chemotherapy. Either way, it is important to report night sweats because it is a common sign of infection and doctors will probably run a series of tests to determine the reason why and rule out an alarming possibility.
7-Swollen lymph nodes
The lymphatic system is an alternate circulation of the blood where a fatty substance called lymph travels along with lymphocytes and other white blood cells. Lymph nodes are dispersed throughout the lymphatic systems, and it is a place of replication in many white blood cell lines. Thus, swelling of these lymph nodes is an important symptom, especially in the early phase of leukemia.
In most cases, swollen lymph nodes point out at an inflammatory or infectious condition in the surrounding tissue. However, there are certain locations and combinations of lymph nodes that may be suggestive of leukemia, and doctors are trained to detect these alterations and run the appropriate tests. Thus, if you don’t feel certain about your symptoms, talk to your doctor and follow his advice.
8-Easy bleeding and bruising
In the blood, there are clotting factors along with red blood cells and white blood cells. They repair bruises and reduce the chance of bleeding, and they are often altered in some cases of leukemia. When the bone marrow of leukemia patients undergo certain structural and functional changes, it is likely that the platelet count goes low, and the patient starts experiencing bleeding and bruising. This may also lead to purple spots, severe menstrual bleeding, bleeding gums, nosebleeds, and much more.
9-Blood clotting and thrombosis
Besides a low platelet count, there are other clotting problems in patients with leukemia. One of them is named disseminated intravascular coagulation, and features the formation of microscopic thrombi, increasing the risk of thrombosis and other vascular complications. This medical condition is common in the onset of the disease, and some patients are diagnosed with leukemia because they had disseminated intravascular coagulation.
10-Anorexia
It is the clinical name of a reduction in appetite, and it is very common in leukemia patients as well as many other patients with cancer. Around 20% of leukemia patients may have appetite problems, and it is likely caused by the increase in the size of the spleen. These patients may also experience nausea and vomiting after a large meal, and they tend to reject food. Additionally, it is known that inflammatory mediators in cancer contribute to making the patient feel satiated and reduce their appetite.
11-Weight loss
As a result of a reduction in appetite along with increased energy consumption, patients with leukemia often experience accelerated weight loss. This is often seen in a late stage of the disease, and the severity of weight loss is often associated with the severity of leukemia and the prognosis of the patient. Weight loss is an important part of the wasting syndrome in cancer called cachexia, which features anorexia, weight loss, fatigue, and muscle wasting. Thus, be attentive and talk to your doctor if you experience a reduction of body weight of 5% or more without any change to your medications, diet or lifestyle.
12-Seizures
In the brain, there are a series of small blood vessels that irrigate and give oxygen to key areas in the neuronal cortex. When the blood becomes thick as a result of leukemia, the normal circulation slows down, and the oxygen supply becomes compromised. This is called leukostasis and often leads to various neurologic symptoms, and seizures are one of the more common. Leukemia patients may also experience loss of consciousness, alterations of the mental status, and respiratory distress as a result of an alteration in the oxygen supply to the brain.
13-Bone pain
Tracing back the origin of the abnormal cells in the blood, we can go down to the bone marrow, where we can find the stem cells that give rise to the abnormal cell lines. In some cases, there will be an accumulation of leukemia cells in the bone marrow, creating pressure and causing bone pain. This symptom is also common in leukemia, especially in older patients, because they are susceptible to low mineralization in the bone tissue with a higher rate of fractures.
Unlike many other types of cancer, leukemia is not found in a single tissue but circulates along with the blood. However, treating this condition has a similar basis, and chemotherapy is one of the most important treatments. Sometimes it will be appropriate to have a stem cell transplantation, but it all depends on the patient and the type of leukemia. In all cases, detecting leukemia in an early stage will contribute to successful treatment and earlier recovery.