Sometimes it’s hard to tell if you have leukaemia, because the signs and symptoms aren’t always obvious. Not everyone will get all, or even any, of the symptoms of leukaemia before they’re diagnosed.
- Blood cancer
- Childhood leukaemia
- Acute lymphoblastic leukaemia (ALL)
- Acute myeloid leukaemia (AML)
- Acute promyelocytic leukaemia (APL)
- Chronic lymphocytic leukaemia (CLL)
- Chronic myeloid leukaemia (CML)
- Chronic myelomonocytic leukaemia (CMML)
- Hairy cell leukaemia (HCL)
- Large granular lymphocytic leukaemia (LGLL)
- Plasma cell leukaemia (PCL)
- T-cell acute lymphoblastic leukaemia (T-ALL)
- Other conditions related to blood cancer
Leukaemia symptoms, signs and diagnosis
Signs and symptoms
If you’re diagnosed with leukaemia, there are some signs and symptoms which you may see or feel before your diagnosis.
It’s important to remember that not everyone will get all, or even any, of these. Each individual is different, and will have a different experience. Some symptoms are common across lots of different types of leukaemia. These are listed below – but don’t forget that you won’t necessarily get all of these symptoms.
Which may cause:
- tiredness that lasts a long time and doesn’t get better with sleep or rest
- breathlessness, even when you’re resting
- chest pain
You might get infections more often than usual, even if there are no clear signs of an infection.
Unexplained weight loss or loss of appetite
Bruising or bleeding
Including bruising more easily and/or bleeding from places you wouldn’t normally expect, like your gums or nose, or seeing bleeding in your stools
Swollen lymph nodes (glands)
Enlarged glands, which you may notice in your neck but they could be in several places around your body, such as your armpit or groin.
Getting the right treatment
Because leukaemia is rare and symptoms like these are common, it can sometimes take some time to diagnose. Once your doctors do suspect leukaemia, they’ll act quickly to make sure you get the tests and treatment you need.
Tests and diagnosis
You’ll have a set of tests to confirm whether you have leukaemia or not. It can be hard to understand how doctors know you have leukaemia, when there’s often nothing like a lump you can see, as you might get with other cancers.
Your doctors diagnose leukaemia by looking at your blood, your bone marrow and your genes. At any time, you can ask your healthcare team to tell you why you’re having a certain test and what the results mean.
Sometimes it can take a few weeks before you get your diagnosis. You may feel anxious whilst waiting for your test results, but it’s very important that your doctor takes this time to understand your illness, so that you have the right treatment.
Many patients say that it helps to keep themselves occupied; talk to family and friends, or other people who’ve been through the same thing.
Here are some of the common tests which people have to diagnose leukaemia. You might also have tests to help give doctors more information about the type of leukaemia you have.
Full blood count
A full blood count (FBC) measures the number of each type of cell in the blood: red cells, white cells and platelets. You might be sent for this test by your GP as part of a routine check-up. Other patients might have one when they’re in hospital for something else.
If your FBC shows that you might have leukaemia, you’ll need to go to hospital for more tests. If you’re diagnosed with leukaemia, you’ll have regular FBCs to monitor your condition.
A blood film is taken from a sample of your blood, which your doctor or hospital team use to look at your blood cells under a microscope. This allows them to see if you have any leukaemia cells in your blood.
Bone marrow aspirate and trephine
In most cases, your doctor will also take a bone marrow sample to see how your blood is working inside your bone marrow. Bone marrow tests provide information about the structure of the marrow and the number and distribution of the different blood cell types – and cancer cells, if present.
Immunophenotyping and cytogenetics
Sometimes you might have genetic tests, but not everyone has them. These tests are called immunophenotyping and cytogenetics. This genetic information helps your healthcare team decide on suitable treatment options, which they’ll discuss with you.
Several lab tests are done on your blood and bone marrow samples that you’ve given. The hospital team will look at the cells under a microscope. They’ll test whether the cells are leukaemia cells by a technique called immunophenotyping, which counts the number of leukaemia cells and determines the type of cells these leukaemia cells are – this shows what type of leukaemia you have.
Leukaemia is caused by genetic errors. Sometimes this happens on a greater scale, which is easy to see under the microscope. Genes are arranged into structures called chromosomes. We have 46 chromosomes, which can sometimes be broken or rearranged. The hospital team will look to see if this has happened. The study of this is called cytogenetics.
General health tests and infection screening
When you’re diagnosed with leukaemia, you’ll have a general health assessment. This will help your healthcare team to assess how you’re likely to cope with side effects from treatment. You’ll have a range of tests to check your general health, including things like your heart, liver and kidney function, and infection screening for HIV and hepatitis.
Remember: you might not have all of these tests – your doctor will talk to you about which tests you’ll need to have. For more information on the tests you’ll have to diagnose a specific type of leukaemia, choose a type from the list .
Staging and risk grouping
For some types of leukaemia, doctors might use the information they get from the results of your tests to classify the cancer, so they can better tell what type of leukaemia you have.
Not everyone who has leukaemia will have the cancer classified in this way, but in some cases it can be helpful for doctors to look at this information to help decide the best treatment for you. Alternatively, doctors might use this information to stage the leukaemia. This describes the extent or severity of a person’s cancer.
Staging for solid cancers, like breast or lung cancer, is based on the size of the original tumour and on how much it spreads from the original site of the tumour. For conditions like leukaemia this isn’t the case, because the leukaemia cells are spread throughout the blood and bone marrow, so doctors often look at the number of affected areas in your body and how much your condition has affected the production of normal blood cells.