Symptoms of acute lymphoblastic leukaemia (ALL)

Symptoms of ALL can be similar to those caused by other illnesses. You may only have one or some of these symptoms if you have ALL.

The symptoms are caused by having too many abnormal white blood cells  and not enough normal white blood cells, red blood cells  and platelets .

Common symptoms of ALL include:

• feeling weak or tired
• shortness of breath
• pale skin
• a high temperature or fever
• picking up or not being able to shake off infections easily
• bruising and bleeding easily
• swelling of your lymph nodes
• pain in your bones or joints
• feeling full or pain in your tummy (abdomen)
• weight loss

Feeling weak or tired

You might feel more tired and weaker than normal, even when you are getting a good nights sleep. This is called fatigue. This can happen if you have a low number of red blood cells. Red blood cells contain haemoglobin, so your haemoglobin level will also be low. Haemoglobin is a pigment that carries oxygen around the body.

Feeling short of breath

You might feel breathless when doing your normal day to day activities or from climbing a short flight of stairs. Some people also feel dizzy. This could be because you do not have enough red blood cells.

Pale skin

You might look paler or more 'washed out' than normal. This could also be because you do not have enough red blood cells.

High temperature or fever

You might have a high temperature or feel feverish. This could be due to an infection or caused by the ALL.

Infections

You might pick up infections such as coughs and colds easily. Or you might find that the infections last a long time and are difficult to shake off.

This is because you don’t have enough healthy white blood cells to fight bacteria or viruses.

Bleeding and bruising

You might have:

• nosebleeds
• bleeding gums when you clean your teeth
• very heavy periods
• small dark red, purple or brown spots on your skin that look like a rash. This is called petechiae
• blood in your wee (urine) or poo (stool)

You might notice you are bruising more easily than normal. This is due to having low platelets, which are a type of blood cell that helps the blood to clot.

Swollen lymph nodes

Your lymph nodes might feel swollen. You have lymph nodes in lots of places in your body. Lymph nodes can be swollen if you have an infection but they usually go back to normal when you have recovered. They aren’t usually painful. You might have swollen lymph nodes:

• in your neck

• under your armpit

• in your groin

Bone and joint pain

You might feel pain in your bones or joints. This might be a dull ache or more of a stabbing pain. It might be worse at different times of the day.

Too many abnormal white blood cells collecting in the bones, joints or lymph nodes may cause pain and swelling.

Feeling full or pain in your abdomen

You might have a feeling of fullness or discomfort in your abdomen. Sometimes this is painful. This can happen if your liver or spleen are swollen.

Weight loss

You might lose weight even if you haven't changed your diet.

Other symptoms

A type of leukaemia called T cell ALL can cause swollen lymph nodes in the centre of your chest. It might also make a gland in your upper chest bigger. This is called the thymus gland. The swollen nodes or thymus gland may press on the windpipe, causing breathlessness and coughing.

They can also press on the veins carrying blood from the head. This causes pressure in the blood vessels and makes the face, neck and arms swell and go red. This is called superior vena cava obstruction (SVCO).

When to see your doctor

You should get any of these symptoms checked by your GP. But remember, they can all be caused by other medical conditions. Most people with these symptoms don’t have leukaemia.