Walsh & Hoyt: Leukemia: Symptoms and Signs

Patients with acute leukemia often experience a prodrome of weakness and malaise, followed by fever, tachycardia, and prostration. About one-third of patients present with symptoms of bleeding. Fever, pain in the bones and joints, petechiae, hemorrhages, and severe secondary infections are also common. Enlargement of the spleen occurs in most patients with acute leukemia, but it is usually only moderate, in which cases the spleen may not even be palpable. Similarly, some types of acute leukemia, particularly the lymphocytic variety, produce generalized lymphadenopathy, whereas other types produce no palpable adenopathy. Many are asymptomatic and diagnosed by hematologic studies performed for other reasons. Patients with chronic leukemias may have their disease for several years before symptoms and signs lead to the diagnosis.