For acute leukemias, many of the early signs are similar to the flu or other common, less serious diseases. In the early stages, chronic leukemias don’t usually cause any noticeable symptoms, and it may take years before symptoms develop. Sometimes chronic leukemias are discovered during a routine blood test. As the disease progresses, symptoms increase and are similar to those seen in acute leukemias.
If you have symptoms of leukemia, your doctor will perform a thorough physical examination and talk to you about your medical history.
Many symptoms of leukemia can be attributed to changes in the number of normal blood cells in your body. Although most people who have the symptoms described below do not have leukemia, you should check with your doctor if you have any of these symptoms.
- Flu-like symptoms, such as fever, sweats, and body aches
- Infections from bacteria or viruses
- Pale skin
- Fatigue, weakness, lack of energy, or sleepiness
- Shortness of breath
- Excessive bleeding or bruising
- Red spots on the palate, ankles, or skin
- Unexplained weight loss
- Pain or aches in the bones, joints, stomach, arms, legs, or back
- Swelling of the abdomen or of the lymph nodes in the neck, underarm, stomach, or groin
During the physical exam, your doctor will check for signs of leukemia, such as swollen or enlarged lymph nodes or spleen. An accurate diagnosis of leukemia requires several diagnostic tests. Typically a complete blood count (CBC) and bone marrow aspiration and biopsy are performed to confirm the diagnosis and look for molecular and chromosomal abnormalities, but any or all of the following tests may be used to diagnose leukemia, determine your treatment options and prognosis, and monitor your disease during and after treatment.
- CBC and peripheral blood smear
- Bone marrow aspiration and biopsy
- Cytogenetic analysis
- Immunophenotyping using flow cytometry
- Fluorescent in situ hybridization (FISH)
- Molecular tests using polymerase chain reaction (PCR)
- Lumbar puncture
- Imaging tests, such as chest X-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, or ultrasound
- Blood chemistry tests
- Other biopsies
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