Symptoms of leukemia vary with the type. The common symptoms of the disease include the following [9]:

• Undue weight loss
• Constant felling of tiredness and fatigue
• Pain in bone
• Fever accompanied by chills
• Excessive sweating especially during night hours
• Easy prone to infections
• Bleeding or bruising very easily
• Hepatomegaly
• Splenomegaly
• Swollen lymph nodes
• Development of petechiae

• Easy Bruising

  Acute leukemia usually develops quickly and tends to cause fatigue, easy bruising, and frequent infections. Chronic leukemia usually develops slowly, with the leukemia cells working almost as well as normal white blood cells. [uabmedicine.org]

  Then also because of the platelets can be affected a lot of times patients will present with bleeding or easy bruising. We sometimes see what we call petechiae, which is just a medical word for small red dot under the skin. [youtube.com]

  However, common signs of the disease include fever, tiring easily, pale skin tone, easy bruising and bleeding, swollen lymph nodes, unplanned weight loss, joint pain and tenderness, night sweats, and frequent infections.4 Myth #4: Survival is rare Reinforce [hematologyadvisor.com]

  Side effects can include hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased chance of infections (due to low white blood cell counts), easy bruising or bleeding (due to low blood platelet counts) and fatigue (due to low [cancersupportcommunity.org]

• Splenomegaly

  Five features were present in 50% of children: hepatomegaly (64%), splenomegaly (61%), pallor (54%), fever (53%) and bruising (52%). [ncbi.nlm.nih.gov]

  Leukemia is usually associated with anemia, fever, hemorrhagic episodes, and splenomegaly. [icd9data.com]

  T-cell prolymphocytic leukemia (T-PLL) is the most common type of mature T-cell leukemia and is characterized by a rapidly rising peripheral blood lymphocyte count, bone marrow involvement, and splenomegaly. [1] The disease in most patients follows an [web.archive.org]

• Fever

  Of the 19 febrile patients in the filgrastim-treated group, the median time for the onset of fever in 18 patients was on day 8 (range, day 1 to day 12); 1 patient experienced fever on day 29. [bloodjournal.hematologylibrary.org]

  Chronic myelogenous leukemia most often begins in the 40s; weight loss, low fever, weakness, and other symptoms may not develop immediately. Chemotherapy helps the symptoms but may not prolong life. [web.archive.org]

  Five features were present in 50% of children: hepatomegaly (64%), splenomegaly (61%), pallor (54%), fever (53%) and bruising (52%). [ncbi.nlm.nih.gov]

  This phase of CML is characterized by fever, weakness, and an enlarged spleen. [britannica.com]

• Anemia

  Anemia and thrombocytopenia are the major adverse prognostic variables. CLL has no standard staging system. [web.archive.org]

  Stage A: The patient does not have anemia or low levels of platelets. The leukemia can be felt in fewer than 3 areas of lymph nodes (Rai stages 0, I and II). Stage B: The patient does not have anemia or low levels of platelets. [cancer.net]

  They also crowd out the normal cells in the marrow, causing a decrease in the number of new normal cells made in the marrow and resulting in a low red cell count (anemia). [hopkinsmedicine.org]

  They also may get anemia, which is when there's a low number of red blood cells. This happens because leukemia cells crowd the bone marrow. This prevents bone marrow from making the usual amount of oxygen-carrying red blood cells. [kidshealth.org]

• Fatigue

  The exercise protocol used increased cardiovascular endurance, reduced fatigue and depression scores, and maintained quality of life. [doi.org]

  Fatigue and weakness iStock/FangXiaNuo Fatigue and weakness are the most common leukemia symptoms, according to Mark Levis, MD, PhD, the director of the leukemia program at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. [rd.com]

  A 21-year-old woman who presented fatigue had a new diagnosis of acute lymphoblastic leukemia underwent FDG PET/CT. The images demonstrated extramedullary infiltration in multiple organs, including the liver, pancreas, kidney and the bone. [ncbi.nlm.nih.gov]

  Fatigue Excessive tiredness is a very common symptom of leukemia. Though there are many causes of fatigue, cancer fatigue tends to be more dramatic than the ordinary tiredness people feel when they lack sleep. [verywellhealth.com]

  / 100.000 4 Leukemia classifiction Acute myelogenous leukemia Acute lymphocytic leukemia chronic lymphocytic leukemia chronic myelogenous leukemia Hairy cell leukemia 5 Symptoms flu -like symptoms: fever, night sweats (unintentional) loss of weight fatigue [flexikon.doccheck.com]

• Weight Loss

  These were petechiae/purpura (category derived from ‘petechiae’, ‘purpura’ and ‘petechiae/purpura’), mucosal bleeding (including ‘mucosal bleeding’ and ‘bleeding gums’), anorexia/weight loss (including ‘anorexia’, ‘weight loss’ and ‘anorexia/weight loss [doi.org]

  Indications to treat include a rapid increase in abnormal cells (doubling in less than six months) and the development of symptoms such as anemia, low platelets, fever, night sweats and weight loss. [froedtert.com]

  Unintentional Weight Loss Unexplained weight loss is a classic sign of all cancers and is generally suggestive of a more advanced malignancy. [verywellhealth.com]

  Other symptoms : There may be nausea, fever, chills, night sweats, flu-like symptoms, weight loss, bone pain, and tiredness. If the liver or spleen becomes enlarged the person may feel full and will eat less, resulting in weight loss. [medicalnewstoday.com]

• Exposure to Benzene

  But some things can increase your risk of getting AML, including: previous chemotherapy or radiotherapy exposure to very high levels of radiation (including previous radiotherapy treatment) smoking and other exposure to benzene, a chemical used in manufacturing [nhs.uk]

  For example, exposure to benzene is a risk factor for AML. It may also be a risk factor for acute lymphocytic leukemia (ALL). [urmc.rochester.edu]

  This includes earlier exposure to chemotherapy, Down’s syndrome and other genetic disorders, exposure to benzene and other chemicals, exposure to radiation therapy etc. [news-medical.net]

• Dyspnea

  Difficulty breathing (dyspnea). With T-cell ALL, these leukemia cells tend to clump together around the thymus. This mass of cells present in the middle of the chest can cause pain and difficulty breathing (dyspnea). [childrensnational.org]

  Difficulty breathing (dyspnea). With T-cell ALL, these leukemia cells tend to clump together around the thymus, a small organ just behind the breastbone. [chop.edu]

  Clinical picture is characterised by dyspnea, spontaneous pneumothoraces, hemoptysis and chylothorax. We present a 43-years old female patient with a history of spontaneous pneumothoraces and lung involvement. [worldcat.org]

  The presenting features most commonly include dyspnea, symptoms of pneumothorax and cough. Less commonly patients can present with chest pain, pleural or pericardial effusion and lymphedema. [bib.irb.hr]

• Abdominal Pain

  Abdominal symptoms such as anorexia, weight loss, abdominal pain and abdominal distension are common. Musculoskeletal symptoms such as limp and joint pain also feature prominently. [ncbi.nlm.nih.gov]

  pain and high levels of bilirubin in the blood (hyperbilirubinemia). [fda.gov]

  Abdominal Pain Abnormal white blood cells may collect in the liver and spleen, causing your abdomen to swell and become uncomfortable. This type of swelling can also decrease your appetite or make you feel full early in a meal. [verywellhealth.com]

• Bleeding Gums

  gums nosebleed ( Epistaxis ) Enlargment of liver and spleen ( Hepatosplenomegaly ) Note : chronic lymphocytic leukemia (CLL) is a low-grade non-Hodgkin lymphoma and causes leukemic symptomes chronic myelogenous leukemia (CML) is a myeloproliferative [flexikon.doccheck.com]

  Symptoms can include: looking pale or "washed out" feeling tired or weak breathlessness frequent infections unusual and frequent bruising or bleeding, such as bleeding gums or nosebleeds losing weight without trying to Seeking medical advice Speak to [nhs.uk]

  You can be very well, maybe a little fatigued, but for the most part feeling yourself and then three weeks later you can have difficulty with bleeding gums, you bump yourself on the kitchen counter and you get a huge bruise instead of a little one. [youtube.com]

  Common symptoms of leukemia may include: fever or night sweats frequent infections feeling weak or tired headache bleeding and bruising easily (bleeding gums, purplish patches in the skin or tiny red spots under the skin) pain in the bones or joints swelling [dph.illinois.gov]

• Hepatomegaly

  Five features were present in 50% of children: hepatomegaly (64%), splenomegaly (61%), pallor (54%), fever (53%) and bruising (52%). [ncbi.nlm.nih.gov]

  Stage II Stage II CLL is characterized by absolute lymphocytosis with either hepatomegaly or splenomegaly with or without lymphadenopathy. [web.archive.org]

  […] means there are high levels of lymphocytes in the blood Lymphadenopathy, meaning a patient has enlarged lymph nodes Splenomegaly, which is an enlarged spleen Anemia, meaning low levels of red blood cells Thrombocytopenia, meaning low levels of platelets Hepatomegaly [cancer.net]

  Bowel Disease, Chronic Sinusitis, Asthma ) Step 2: Indications to proceed with Peripheral Smear Leukocytosis without other secondary cause (or despite treatment) White Blood Cell Count 20,000/mm3 Associated Anemia, Thrombocytopenia or Thrombocytosis Hepatomegaly [fpnotebook.com]

• Hepatosplenomegaly

  Note : chronic lymphocytic leukemia (CLL) is a low-grade non-Hodgkin lymphoma and causes leukemic symptomes chronic myelogenous leukemia (CML) is a myeloproliferative disease (MPD) and causes leucemic and MPD symptoms (e.g. hepatosplenomegaly, blast [flexikon.doccheck.com]

  T-cell large granular lymphocytic leukemia is a rare form of leukemia, caused by clonal proliferation of cytotoxic T-cells, characterized by modest lymphocytosis and cytopenias of other lineage with hepatosplenomegaly and relatively rare lymph nodal involvement [ncbi.nlm.nih.gov]

  Hepatosplenomegaly and lymphadenopathy are rare in adults with acute myelogenous leukemia, but are present in about 50% of adults with acute lymphoblastic leukemia. 12 Central nervous system involvement occurs in approximately 5% to 8% of adults with [aafp.org]

  Stage I Stage I CLL is characterized by absolute lymphocytosis with lymphadenopathy without hepatosplenomegaly, anemia, or thrombocytopenia. [web.archive.org]

• Petechiae

  Where considered clinically appropriate, features that the authors considered similar were aggregated (eg, ‘petechiae’, ‘purpura’ and ‘petechiae/purpura’ were combined into a single category, ‘petechiae/purpura’). [doi.org]

  We sometimes see what we call petechiae, which is just a medical word for small red dot under the skin. We frequently will see that at least initially in the lower part of your body, say below your knees, ankles and feet. [youtube.com]

  An additional eight features were present in a third to a half of children: recurrent infections (49%), fatigue (46%), limb pain (43%), hepatosplenomegaly (42%), bruising/petechiae (42%), lymphadenopathy (41%), bleeding tendency (38%) and rash (35%). [ncbi.nlm.nih.gov]

  Small red dots on your skin—a condition known as petechiae—could also result from leukemia, she adds. "Petechiae usually appears on the lower extremities," Wadleigh adds. [prevention.com]

  Petechiae (small red spots under the skin caused by bleeding) iStock/lzf Dr. Crilley describes petechiae as “like someone painted little red dots with a pen.” [rd.com]

• Urticaria

  Urticaria was seen in 9 patients (23%) but was usually mild and transient. No patient experienced significant fluid retention. [dx.doi.org]

  The disease starts as urticaria-like lesions, with multiple cutaneous nodules that may regress and subsequently reappear. In this form of leukosis, the enzootic bovine leukosis virus has not been identified. [ncbi.nlm.nih.gov]

• Purpura

  Where considered clinically appropriate, features that the authors considered similar were aggregated (eg, ‘petechiae’, ‘purpura’ and ‘petechiae/purpura’ were combined into a single category, ‘petechiae/purpura’). [doi.org]

  […] bleeding, such as bleeding gums or nosebleeds high temperature night sweats bone and joint pain easily bruised skin swollen lymph nodes (glands) tummy (abdominal pain) – caused by a swollen liver or spleen unintentional weight loss a purple skin rash (purpura [nhs.uk]

  […] classified as palpable purpura or non-palpable purpura and indicates various pathologic conditions such as thrombocytopenia),[7] The term ecchymosis (defined as an area of 1 cm) is synonymous.[2] As a type of hematoma, a bruise is always caused by internal [en.wikipedia.org]

• Eczema

  Birth order and sibship size as independent risk factors for asthma, allergy, and eczema. Pediatr Allergy Immunol. 2003; 14 (6):464–469. [ PubMed ] [ Google Scholar ] 49. Lewis SA, Britton JR. [ncbi.nlm.nih.gov]

• Bone Pain

  pain or tenderness These symptoms are often vague and can resemble the flu, so it’s important for patients to be aware of changes in their body and make an appointment to see their doctor if they have any concerns. [utswmed.org]

  So, it's more generalized bone pain. So, if a patient starts showing signs and symptoms of leukemia, a doctor will often start off by getting a blood test, and if they get a blood test, the first thing that you will see is this picture over here. [khanacademy.org]

  This may result in infections, anemia, and easy bleeding, as well as bone pain and pain or a feeling of fullness below the ribs on the left side. [westcancercenter.org]

  Some patients have bone pain or joint pain caused by leukemic cells spreading from the marrow cavity to the surface of the bone or into the joint. [web.archive.org]

• Arthralgia

  Other side effects included rashes in 4%, arthralgias in 5%, and fatigue in 3%. The preliminary phase II studies of nilotinib in accelerated and blastic phase CML post Gleevec failure were also encouraging. [web.archive.org]

• Epistaxis

  […] lymphocytic leukemia chronic lymphocytic leukemia chronic myelogenous leukemia Hairy cell leukemia 5 Symptoms flu -like symptoms: fever, night sweats (unintentional) loss of weight fatigue syndrome (extreme weakness) swollen or bleeding gums nosebleed ( Epistaxis [flexikon.doccheck.com]

  The animal with acute myeloid leukemia presents with depression, epistaxis, anemia, and severe neutropenia. [ncbi.nlm.nih.gov]

• Hematuria

  When patients developed hematuria, muscle weakness, or even asymptomatic elevation of CK levels, physicians should pay attention to the occurrence of rhabdomyolysis and take active hydration treatment. [ncbi.nlm.nih.gov]

  People with acute promyelocytic leukemia are especially susceptible to developing bruises, small red dots under the skin (petechiae), nosebleeds, bleeding from the gums, blood in the urine (hematuria), or excessive menstrual bleeding. [ghr.nlm.nih.gov]

  In spite of appropriate antibiotic and antifungal therapy, pneumonia was aggravated and gross hematuria was accompanied. [cancerindex.org]

• Headache

  Headaches and Other Neurological Symptoms Headaches and other neurologic symptoms such as seizures, dizziness, visual changes, nausea, and vomiting may occur when leukemia cells invade the fluid surrounding the brain and spinal cord (cerebrospinal fluid [verywellhealth.com]

  Some of the symptoms are like those seen with a stroke, and include: Headache Weakness in one side of the body Slurred speech Confusion Sleepiness When blood vessels in the lungs are affected, people can have shortness of breath. [cancer.org]

  Pounding headaches iStock/AZarubaika Although not common, frequent pounding headaches may be a sign of leukemia-related anemia or even a life-threatening case of bleeding in the head. These are the signs of cancer men are most likely to ignore. [rd.com]

  You must lie flat for several hours afterward to keep from getting a headache. The lab checks the fluid for leukemia cells or other signs of problems. [hopkinsmedicine.org]

  Common symptoms of leukemia may include: fever or night sweats frequent infections feeling weak or tired headache bleeding and bruising easily (bleeding gums, purplish patches in the skin or tiny red spots under the skin) pain in the bones or joints swelling [dph.illinois.gov]

• Peripheral Neuropathy

  Peripheral neuropathy – Peripheral neuropathy, or numbness, tingling or pain in the hands and feet, can last months after therapy with agents such as Oncovin. [hopkinsmedicine.org]

  Testing for peripheral neuropathy before and while on levodopa is also very important. Patients should also be regularly monitored for dyskinesia. [ncbi.nlm.nih.gov]

The following are the various diagnostic procedures for detecting leukemia [10]:

• A preliminary physical examination will be carried out for studying the various signs and symptoms of leukemia.
• Blood tests such as complete blood count provide a useful insight for diagnosis of the condition. 
• Bone marrow test forms an important part of the diagnostic procedure. In this a sample of the bone marrow is derived from the hip bone and studied for the presence of leukemia cells.

• Hyperviscosity

  Paraneoplastic syndromes in malignant lymphomas manifest by anemia, hypercalcemia, blood hyperviscosity, cachexia and other less frequent forms. [ncbi.nlm.nih.gov]

  Waldenström macroglobulinemia has a natural history and therapeutic options similar to CLL, with the exception of hyperviscosity syndrome associated with macroglobulinemia as a result of elevated immunoglobulin M. [cancer.gov]

• Leukocytes Decreased

  Regardless of the treatment instituted, the leukocyte formula should be monitored, and treatment should be suppressed when the number of leukocytes decreases below 3000/mm 3 or when the number of blood platelets decreases below 100000/mm 3 ; antibiotherapy [ncbi.nlm.nih.gov]

Treating leukemia is a complex process as it would greatly depend on the stage of the disease and the type of leukemia present. Some of the common treatment methods employed for treating the condition are explained below [11]:

• Chemotherapy: It is the method of choice for treating leukemia [11].
• Biological therapy: In this method, therapies are targeted towards making the immune system recognize the cancer cells as invaders and attack them.
• Radiation therapy: Radiation therapy employs high beam radiation to kill the target cells and arrest their growth. 
• Targeted therapy: In this form of therapy, drugs are administered that attack specific component of the leukemia cells thereby preventing their growth and multiplication.
• Stem cell transplant: In this, the affected bone marrow is transplanted with a healthy one. The prognosis of the disease is favorable with this kind of method [12]. Prior to this method, the patient is given chemotherapy in combination with radiation therapy to completely destroy the diseased bone marrow.

Prognosis of the disease condition depends on the type of leukemia and the stage at which the condition was diagnosed. If leukemia is diagnosed in its early stages then the prognosis is favorable with timely initiation of treatment and regular follow up checkups [8].

The factor that triggers the development of leukemia is yet to be figured out. However, a combination of various factors such as environment and heredity are known to play foul. In addition, various types of risk factors such as exposure to chemical compounds such as benzene, tobacco smoking, ionizing radiation and prior treatment with chemotherapy can also predispose an individual to develop leukemia [3] [4].

Leukemia is a widespread problem affecting the male and female population equally. It has been estimated that every year about 13.0 per 100,000 fresh cases of leukemia are diagnosed. Statistics also reveal that there were about 7.0 per 100,000 cases of death due to leukemia every year. Researchers have also established statistical data which state that in the year 2014, there would be 52,380 new cases of leukemia. Of these, 24,090 cases of death due to leukemia would also occur in the same year. Statistical data has also confirmed that leukemia accounts for 4.1% of all cancer deaths. This form of cancer is also widely prevalent amongst the pediatric population [5] [6]. It has been estimated that each year in US about 2500 – 3500 new cases are diagnosed [1].

Leukemia begins with attacking the white blood cells of the body. As a result of this, the infection fighting ability of the white blood cells is greatly diminished making the body more prone to contract infectious diseases. Leukemia also affects the bone marrow as a result of which abnormal cells are produced which fail to function in the normal way. Such sequence of events causes the abnormal cells to affect other body organs such as the liver, eye and the spleen. There are basically 4 types of leukemia, namely: Acute lymphocytic leukemia, acute myelogenous leukemia, chronic lymphocytic leukemia and chronic myeloid leukemia. Other rare types of leukemia are myeloproliferative disorders, hairy cell leukemia and myelodysplastic syndromes [7].

It is practically not possible to prevent leukemia. However, the spread of the disease can be prevented if detected on time and timely initiation of treatment.

There are several forms of leukemia; some which affect the children and some which affect the adult population. Leukemia usually begins by primarily attacking the white blood cells which are essential for warding off infections. But, when the cancer affects the white blood cells, these are no longer capable of safeguarding the body against infections. The underdeveloped white blood cells are known as blasts or leukemia cells [2]. Treatment of leukemia is a complex process that needs to be designed keeping in mind several factors.

Definition

Leukemia is the cancer of the white blood cells that also affects the lymphatic system and the bone marrow. It is a common condition affecting the children as well as the adult population.

Cause

The exact factor that triggers the abnormal development of cells is not clearly understood. However, interplay of environment and genetic factors are known to play foul in causation of leukemia.

Symptoms

Symptoms of leukemia include fatigue, tiredness, unexplained weight loss, fever and chills, frequent nose bleeds, excessive sweating and bone pain along with tenderness.

Diagnosis

Diagnosis of leukemia is done by blood tests to determine complete blood count which would give an idea about the white blood cell count. In addition to this, bone marrow test is also done to analyze for the presence of leukemia cells.

Treatment

Treatment of leukemia consists of chemotherapy and radiation therapy which targets the cancer cells and destroys them. In addition, stem cell transplant is also the method of choice wherein the diseased bone marrow is replaced with a healthy one. Patients suffering from leukemia are also given targeted therapy which works by destroying specific components of the leukemia cells.

1. Ward E, DeSantis C, Robbins A, et al. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin 2014; 64:83.
2. Rootman J, Gudauskas G. Treatment of ocular leukemia with local chemotherapy. Cancer Treat Rep. Jan 1985;69(1):119-22
3. Kincaid MC, Green WR. Ocular and orbital involvement in leukemia. Surv Ophthalmol. Jan-Feb 1983;27(4):211-32.
4. Buffler PA, Kwan ML, Reynolds P, Urayama KY. Environmental and genetic risk factors for childhood leukemia: appraising the evidence. Cancer Invest 2005; 23:60
5. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014; 64:9.
6. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. Mar-Apr 2005;55(2):74-108. [Medline]. Galton DA. The pathogenesis of chronic lymphocytic leukemia. Can Med Assoc J 1966; 94:1005.
7. Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 1999; 17:3835.
8. Jonsson OG, Sartain P, Ducore JM, Buchanan GR. Bone pain as an initial symptom of childhood acute lymphoblastic leukemia: association with nearly normal hematologic indexes. J Pediatr 1990; 117:233.
9. Kaufman M, Rubin J, Rai K. Diagnosing and treating chronic lymphocytic leukemia in 2009. Oncology (Williston Park). Nov 15 2009;23(12):1030-7.
10. Harnett AN, Plowman PN. The eye in acute leukaemia. 2. The management of solitary anterior chamber relapse. Radiother Oncol. Nov 1987;10(3):203-7. 
11. Kerty E, Vigander K, Flage T, Brinch L. Ocular findings in allogeneic stem cell transplantation without total body irradiation. Ophthalmology. Jul 1999;106(7):1334-8.
12. Rootman J, Gudauskas G. Treatment of ocular leukemia with local chemotherapy. Cancer Treat Rep. Jan 1985;69(1):119-22.