Leukemia (leukaemia): symptoms and signs of blood cancer

Leukemia is a group of malignant diseases of the hematopoietic system in which the bone marrow produces abnormal blood cells. Early manifestations are rarely specific: fatigue, fever, bruises and red spots on the skin. Below is what is described as signs of leukemia and how it is detected.

What is leukemia (leukaemia, white blood disease)

Leukemia is a general name for malignant diseases of blood cells, that is, blood cancer. The process begins in the hematopoietic tissues, primarily in the bone marrow, which produces leukocytes, erythrocytes and platelets. In leukemia, the marrow forms many abnormal cells, most often of the leukocyte lineage: they accumulate in the bone marrow and blood, displace healthy cells and interfere with their function.

Forms are divided by cell type (lymphocytic, myeloid) and by tempo: acute forms grow quickly, chronic forms slowly. Acute lymphoblastic leukemia is the most common cancer in children and also occurs in adults; chronic lymphocytic leukemia is one of the most common in adults.

The exact causes are unknown: what is involved is changes in the genetic material of bone marrow cells. Risk is associated with past chemotherapy and radiotherapy, hereditary disorders, contact with chemicals, and smoking; leukemia is more often detected after age 60.

First signs of leukemia

Tumor tissue grows in the bone marrow and replaces normal hematopoietic lineages; cytopenias develop — anemia, thrombocytopenia, lymphocytopenia, granulocytopenia. Hence bleeding, hemorrhages and suppressed immunity with infections.

• fatigue;
• fever or night sweats;
• easily occurring bruises and bleeding;
• weight loss or loss of appetite;
• petechiae — small red spots under the skin due to hemorrhages.

In chronic leukemias there may be no symptoms at the start. None of these signs is specific: they are a reason for examination and a complete blood count.

Bone pain and changes in organs

The tumor initially grows where the bone marrow is located, and metastasis produces infiltrates in the liver, spleen and lymph nodes. Blockage of vessels by tumor cells leads to infarcts and ulcerative-necrotic complications.

Bone pain is not among the described symptoms. The bones are relevant as a way to obtain material for diagnosis: trephine biopsy of the iliac crest or sternal puncture.

Skin and bleeding

Skin signs are associated not with the skin as such but with platelet deficiency: petechiae, easily occurring bruises and bleeding. The diagnosis is not made by the appearance of the skin; blood is tested — a complete blood count with a leukocyte differential.

Symptoms of leukemia in women

No separate "female" symptoms are distinguished in the descriptions: fatigue, fever and night sweats, bruises, bleeding, weight loss, petechiae — the list is the same for both sexes. The age profile differs: chronic forms are more common in middle and older age, acute myeloid in the elderly, and leukemia is most often detected after age 60.

How leukemia is detected and when to see a doctor

It begins with examination and medical history, then a complete blood count with a leukocyte differential. The key is morphological examination of a blood smear and a bone marrow sample (sternal puncture or trephine biopsy of the iliac crest). Next are genetic tests, and after confirmation of the diagnosis, imaging studies and lumbar puncture.

Reference points: in acute leukemia blasts are more than 30%, more often 60–90%, with a "leukemic gap"; in chronic leukemias blasts are less than 30%, more often 1–2%.

With persistent unexplained fatigue, recurring fever and night sweats, easy bruising, bleeding, petechiae, or weight loss, a doctor's consultation and a complete blood count are needed. A combination of signs is concerning, not a single episode.

Petechiae and bruises by themselves are not a reason to call an ambulance; 103/112 — for a life-threatening condition: severe bleeding, loss of consciousness, difficulty breathing.

The material is for reference: it describes signs and examinations but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer