Leukemia--Acute Lymphocytic Overview

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Early Detection, Diagnosis, and Staging TOPICS

Signs and symptoms of acute lymphocytic leukemia

Certain signs and symptoms could suggest that a person might have acute lymphocytic leukemia. But tests always are needed to confirm this. And keep in mind that these symptoms are most often caused by something other than cancer.

General symptoms

General symptoms of ALL can include:

  • Weight loss (without trying)
  • Severe night sweats (that drench the sheets)
  • Tiredness
  • Fever
  • Loss of appetite

Of course, ALL is not the only thing that causes these symptoms. They are most often caused by something other than cancer.

Problems caused by low blood cell counts

Most symptoms of ALL are caused by a shortage of normal blood cells, which happens when the leukemia cells crowd out normal blood-making cells in the bone marrow. As a result, the person doesn't have enough normal red blood cells, white blood cells, and platelets. These shortages show up on blood tests, and they can also cause symptoms.

  • Anemia is a shortage of red blood cells. It can cause a person to feel tired, weak, dizzy, cold, lightheaded, or short of breath.
  • A shortage of normal white blood cells increases the risk of infections. Although people with leukemia may have very high white blood cell counts, the cells are often not normal and cannot protect against infection. Fevers and other signs of infection are common symptoms of ALL.
  • A shortage of blood platelets can lead to easy bruising, bleeding, frequent or severe nosebleeds, and bleeding gums.

Problems caused by spread or buildup of leukemia cells

Swelling in the belly: Leukemia cells may collect in the liver and spleen, causing them to swell. This may be noticed as a fullness or swelling of the belly.

Swollen lymph nodes: ALL can spread to lymph nodes. If the nodes are close to the surface of the body, they may be noticed as lumps under the skin. Lymph nodes inside the chest or belly (abdomen) may also swell, but these can only be seen on tests like CT or MRI scans.

Spread to other organs: Less often, ALL can spread outside of the bone marrow to other organs. If it spreads to the brain or spinal cord (central nervous system), it can cause symptoms like headaches, weakness, seizures, vomiting, trouble with balance, or blurred vision. ALL may also spread to the chest, where it can cause fluid build-up and trouble breathing.

Bone or joint pain: Some patients have bone pain or joint pain caused by the build-up of leukemia cells in bones or joints.

Spread to other organs: Less often, ALL will spread to other organs, where it may form tumors.

Symptoms from an enlarged thymus: One type of ALL (the T-cell subtype) often affects the thymus, which is a small organ in the middle of the chest behind the breastbone and in front of the windpipe. A swollen thymus can press on the windpipe, causing coughing or trouble breathing. A large vein, the superior vena cava (SVC) that carries blood from the head and arms back to the heart, also passes next to the thymus. If the thymus presses on the SVC, it can make the head and arms swell (this is called SVC syndrome). This can affect the brain and is life threatening. People with SVC syndrome need treatment right away.


Last Medical Review: 06/25/2013
Last Revised: 02/07/2014