Acute Lymphocytic Leukemia Symptoms and Signs

April 19, 2024 
This page was reviewed under our medical and editorial policy by Guido Marcucci, M.D., Chair, Department of Hematologic Malignancies Translational Science, City of Hope Duarte

Acute lymphocytic leukemia (ALL) is a type of blood cancer, but not all patients with ALL have symptoms. When patients do have symptoms, they may be mild or vague in nature, so the disease may first be mistaken for another condition.

This guide provides patients and their families information about the symptoms and signs of acute lymphocytic leukemia.

ALL Symptoms

Symptoms of ALL may vary depending on subtype, and not all patients experience all symptoms. Some patients may notice none at all, especially in the early stages.

The following symptoms are most commonly associated with acute lymphocytic leukemia.

Symptoms Related to Low Blood Cell Counts

Some symptoms of ALL are caused by low blood cell counts, as cancer cells crowd out healthy blood cells in the bone marrow. Symptoms related to low blood counts may include:

• Feeling tired, weak or lightheaded
• Pale skin
• Shortness of breath
• Recurrent infections
• Frequent bruising or bleeding, including nosebleeds

General ALL Symptoms

Patients may experience more general symptoms, which may be vague in nature. These may include:

• Fever
• Night sweats
• Unexplained loss of appetite
• Unexplained weight loss

Symptoms Associated with ALL Spreading to Other Areas of the Body

If acute lymphocytic leukemia spreads to other parts of the body, the symptoms listed below may be present.

Enlarged lymph nodes: When ALL spreads to lymph nodes near the skin, it may cause lumps, such as under the arms or on the neck.

Abdominal swelling: Swelling in the abdominal area, or a feeling of being full without eating a big meal, may occur if ALL is present in abdominal organs, such as the spleen and liver.

Joint or bone pain: This may be felt if ALL spreads into the joints or near the surface of the bone.

Difficulty breathing: Fluid buildup in the chest cavity and breathing problems may happen when ALL is inside the chest.

Headaches, blurred vision, loss of balance: These symptoms may develop if ALL is in the spinal cord and brain.

Additional symptoms may occur, depending on the cancer subtype. While ALL symptoms may sometimes be uncomfortable, each patient’s health care team is available to help with symptom management and ongoing support.

ALL Signs

Certain signs are associated with acute lymphocytic leukemia. While symptoms are changes to the body that are noticed by the patient, signs are measurable indicators from a medical test that may mean a disease is present.

Signs of ALL may include those listed below.

Abnormal blood cell counts: Low levels of red blood cells and platelets, along with high, normal or low levels of white blood cells found in a complete blood count (CBC) blood test.

Neutropenia: Neutropenia is a low count of a specific type of white blood cell called a neutrophil. These cells play an important role in preventing infection, so when neutropenia is present, a patient may have a harder time preventing infections. Neutropenia is found through a blood test.

These and other tests may be performed for patients experiencing symptoms as part of the acute lymphocytic leukemia diagnosis process.