Leukemia Symptoms

Medically Reviewed by Zilpah Sheikh, MD on April 30, 2024
Written by Frances Gatta
7 min read

Many types of leukemia produce no obvious symptoms in the early stages. Eventually, symptoms may include any of the following:

  • Loss of appetite and weight
  • Discomfort under the left lower ribs (caused by a swollen spleen)
  • Very high white blood cell counts, which may lead to vision problems due to bleeding in the retina, ringing of the ears (tinnitus), mental status changes, prolonged erection (priapism), and stroke

Leukemia red spots

Leukemia red spots are an early warning sign of leukemia. These tiny red spots, which a doctor may call petechiae, look like a rash. But they are not. They happen due to bleeding under the skin. They may appear on any body part, but common areas include

  • Inside the eyelids
  • Mouth
  • Arms
  • Butt
  • Legs
  • Stomach

Leukemia red spots may also look like purple or brown spots. You can tell a leukemia red spot from a rash by pinching the spot. Leukemia red spots will remain red, brown, or purple, while a rash will turn pale. Unlike a rash, leukemia red spots don’t itch and aren't painful. Leukemia red spots may also happen due to other reasons such as an infection, injury, or side effects from medication.

Leukemia is the most common cancer in children, accounting for about 28% of all cancer cases in children. The most common types are acute lymphocytic leukemia and acute myeloid leukemia. They cause symptoms such as:

  • Pale skin
  • Bone and joint pain
  • Tiredness
  • Weight loss
  • Weakness
  • Easily bleeding or bruising
  • Fever
  • Feeling cold
  • Dizziness or lightheadedness
  • Difficulty breathing
  • Headaches
  • Seizures
  • Vomiting
  • Frequent or serious nosebleeds
  • Belly swelling
  • Bleeding gums
  • Face swelling
  • Coughing

The warning signs of leukemia include:

  • Flu-like symptoms, such as fever and chills
  • Weakness
  • Tiredness
  • Bleeding or bruising easily
  • Unexplained weight loss
  • Appetite loss
  • Night sweats
  • Tiny red spots
  • Frequent infections
  • Swollen or bleeding gums
  • Bone and joint pain
  • Low levels of healthy red blood cells

These symptoms look like symptoms of many other conditions, some of which may not be as serious as leukemia. See a doctor about your symptoms to know why you have them.

What is the first sign of leukemia?

The first signs of leukemia will depend on the type of leukemia you may have. These symptoms may also look like those of common illnesses. Unlike common, easily treatable illnesses, you’ll also have these symptoms for over 2 weeks. The first symptoms you might get with leukemia include:

Tiredness. You may feel tired all the time because you don’t have enough red blood cells carrying oxygen to your cells.

Loss of appetite. You may not feel like eating because your spleen has enlarged and is pressing on your stomach, causing you to feel full.

Fever and chills. These symptoms may occur when there aren't enough healthy white blood cells to fight off pathogens, causing frequent infections.

Night sweats. Scientists have yet to understand why this symptom happens.

Red spots in the skin. Not having enough cells that help with blood clotting, called platelets, may cause you to have red spots in your skin and easily bleed and bruise.

Your symptoms may become more distressing in the advanced stages of leukemia. They may include:

  • Taking slow breaths with long pauses in between
  • Stuffy nose and noisy breathing
  • Mouth and lip dryness
  • Restlessness
  • Hallucinations and dream-like experiences
  • Cool-to-touch skin that turns bluish or dusky
  • Passing less urine
  • Loss of bladder and bowel control
  • Confusion about people, time, and place
  • Loss of consciousness and responsiveness

What are some of leukemia’s skin symptoms?

Leukemia may also cause symptoms that involve your skin, including:

  • Pale skin
  • Red, brown, or purplish spots in your skin that may be called leukemia rash or leukemia red spots
  • Skin bruises
  • Easily bleeding
  • ​​Lumps under the skin

What is leukostasis?

Leukostasis is a condition that happens when cancer cells called blasts, which are larger than normal white blood cells, multiply and clog up blood vessels. As a result, normal red blood cells and oxygen can’t reach tissues. Although rare, it is life-threatening and needs immediate medical attention. Its symptoms are the same as those of stroke and include:

  • Headache
  • Slurred speech
  • Weakness on one side of the body
  • Confusion
  • Sleepiness
  • Shortness of breath
  • Blurry vision
  • Vision loss

See a doctor immediately if you show these symptoms, whether or not you’ve been diagnosed with leukemia.

The relationship between leukemia and anemia

Anemia is when a person has lower-than-normal levels of healthy red blood cells. It often happens in people with leukemia because cancer cells multiply very quickly, limiting how many red blood cells the body produces. Anemia may contribute to death in people with leukemia. If you have leukemia, you may also have anemia symptoms such as:

  • Tiredness
  • Weakness
  • Feeling cold
  • Difficulty breathing
  • Dizziness or lightheadedness
  • Headaches
  • Pale skin

Acute myeloid leukemia symptoms

Acute myeloid leukemia is a common cancer in children but happens more often in adults. Symptoms may include:

  • Fever
  • Difficulty breathing
  • Red spots under the skin
  • Easily bleeding or bruising
  • Tiredness
  • Weakness
  • Loss of appetite
  • Unexplained weight loss

Chronic myeloid leukemia symptoms

This type of leukemia, also called chronic myelogenous leukemia, affects middle-aged or older adults. You can have chronic myeloid leukemia and show no symptoms. But when you do, they may include:

  • Tiredness
  • Night sweats
  • Unexplained weight loss
  • Fever
  • Pain or a feeling of fullness in the lower left rib area

Acute lymphoblastic leukemia symptoms

Acute lymphoblastic leukemia is the most common type of cancer in children. It also occurs in adults. Symptoms may include:

  • Tiredness
  • Weakness
  • Loss of appetite
  • Unexplained weight loss
  • Night sweats
  • Difficulty breathing
  • Red spots under the skin
  • Bone pain
  • Stomach pain
  • Pain or fullness under the ribs
  • Lumps in the neck, stomach, groin, or under the arm
  • Frequent infections
  • Fever
  • Easily bleeding or bruising

Chronic lymphocytic leukemia symptoms

Chronic lymphocytic leukemia is the most common leukemia in adults in Western countries. It makes up 25%-30% of leukemia cases in the U.S. You may show no symptoms at first. However, over time, you may start having symptoms such as:

  • Tiredness
  • Weakness
  • Pain or a feeling of fullness under the ribs
  • Swollen lymph nodes
  • Fever
  • Frequent infections
  • Bruising or bleeding easily
  • Red spots
  • Unexplained weight loss

At first, you may have no symptoms or symptoms that look like those of other common illnesses, such as a common cold. But if your symptoms continue for up to 2 weeks, see a doctor for a test. Aside from doing a physical exam and asking about your medical history, your doctor may also perform blood tests, bone marrow tests, and genetic tests to determine the cause of your symptoms.

At first, leukemia may cause many symptoms that are similar to less serious health conditions. But as it progresses, symptoms may become more noticeable, distressing, and potentially life-threatening. See a doctor immediately about any new unexplained symptoms that don’t go away whether or not you’ve been diagnosed with leukemia. Also, if you suddenly have symptoms of leukostasis such as headache, body weakness, and confusion, visit a doctor right away.

What is the survival rate for leukemia?

About 67% of people diagnosed with leukemia may survive for 5 years or more.

How long can leukemia go undiagnosed?

Acute leukemia symptoms show up quickly, are life-threatening, and require immediate medical attention. Chronic leukemia symptoms show up slowly, and you may have it for years without showing any symptoms.