Leukemia Symptoms


The symptoms of leukemia usually come on suddenly within days or weeks. However, the initial signs can sometimes be difficult to recognize because the early indicators of acute leukemia are often similar to the flu. Furthermore, with chronic myeloid or lymphocytic leukemia, the abnormal leukemia cells can function almost as well as normal white blood cells. As a result, many people with this condition only learn there is a problem when they have routine blood work done.

Signs & symptoms of leukemia

Leukemia symptoms will vary from one patient to another based on a number of different factors, such as the type of leukemia present and the person’s age and overall health. With that being said, there are a number of common leukemia symptoms, many of which can indicate the first signs of this disease. They include:

  • Weakness and fatigue
  • Fever or chills
  • Pale skin
  • Easy bruising or bleeding
  • Frequent infections
  • Petechiae (small blood spots under the skin)
  • Heightened sensitivity to hot and cold temperatures
  • Bone pain or tenderness
  • Painless lumps in the neck, underarm, stomach or groin
  • Enlarged liver or spleen, which can cause tenderness below the ribcage on the left side of the body
  • Swelling and discomfort in the midsection
  • Reduced appetite
  • Weight loss
  • Aplastic anemia
  • Chronic nosebleeds
  • Excessive sweating, particularly at night

These symptoms typically worsen over time, especially in cases involving acute myeloid and acute lymphocytic leukemia, since these types tend to grow more quickly and produce more symptoms than chronic forms of leukemia.

What are petechiae?

One of the symptoms that leukemia patients and their loved ones tend to have the most questions about is petechiae. What exactly are these pinpoint-sized spots, and how are they related to leukemia? Petechiae develop when a capillary (a small blood vessel) breaks under the skin’s surface. Normally, platelets would help the blood to clot so that it wouldn’t escape the broken capillary. However, because leukemia lowers platelet counts, it can prevent this process from occurring. Rather than clotting, the blood exits the capillary and rises toward the surface of the skin, forming the tiny spots known as petechiae.

Although petechiae are typically red, they can also present as purple or brown spots. Some of the most common areas to find petechiae include the:

  • Arms
  • Stomach
  • Buttocks
  • Legs

Petechiae often resemble a common skin rash unassociated with leukemia. However, there’s a distinguishing characteristic that sets the two apart. When pressure is applied to a rash, the skin will usually turn white. But when pressure is applied to petechaie, the spots will remain the same color.

Petechiae are not exclusive to leukemia. In fact, they’re associated with a number of other conditions (such as strep throat, scarlet fever, scurvy and sepsis) and can also be a side effect of certain medications (including blood thinners, sedatives and antidepressants). And in some instances, they can result from an injury or develop when a blood vessel in the face, neck or chest is strained and tears (for example, this can occur while coughing, vomiting or weightlifting). Although petechiae don’t definitively signal the presence of leukemia, they should still be checked out by a trained medical professional, especially if other leukemia symptoms are present.

What does leukemia bone pain feel like?

Many patients are also curious about leukemia bone pain. Is it similar to regular joint pain and muscle aches, or is it easy to recognize? One of the main distinguishing factors is that while joint pain and muscle aches usually flare up after activity, leukemia bone pain tends to linger during rest. However, it can be difficult to describe what leukemia bone pain feels like, since some patients report sharp pain and others liken it to a dull, continuous ache.

Because leukemia bone pain tends to develop in the areas of the body where there are particularly large amounts of bone marrow, it’s common to experience pain in the:

  • Breastbone (sternum)
  • Arms
  • Ribcage
  • Hips
  • Legs

Moffitt Cancer Center’s approach to leukemia

Many of the signs and symptoms of leukeumia can be relatively mild, and the only way to be certain of the source is to see a specialist for a full evaluation and diagnosis. The multispecialty leukemia team in Moffitt Cancer Center’s Malignant Hematology Program is highly experienced in identifying and treating all types of blood cancers. Our team can diagnose your condition, determine the proper treatment and answer any questions that you might have about leukemia. As the only National Cancer Institute-recognized Comprehensive Cancer Center based in Florida, we offer a number of innovative treatments and clinical trials you can’t find anywhere else in the region.

Medically reviewed by Leidy Isenalumhe, MD, Malignant Hematology.

To learn more about the most common leukemia symptoms, call 1-888-663-3488 and request an appointment with one of our oncologists specializing in leukemia. Or, use our convenient new patient registration form online. When you reach out to us, we’ll connect you with a cancer expert within just one day.