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Symptoms

The possible symptoms of chronic myeloid leukaemia (CML) and when to see your doctor.

About 1 in 4 people with CML (25%) have no symptoms at all when they are diagnosed. Their CML is picked up on a routine blood test and many of their symptoms are likely to be caused by other illnesses. When symptoms occur they are usually mild at first and gradually get worse.

As the numbers of abnormal white blood cells rises, you may pick up infections more easily. This is because the abnormal white blood cells cannot fight off infection as well as healthy ones.

CML can use up energy that your body would otherwise use or store. So you may lose weight, even if you think you are eating normally.

If you have a very enlarged spleen, you may feel full more quickly than usual because the spleen is squashing your stomach. This may make you eat less and lose weight.

It is common for people with CML to feel very tired. This is because your bone marrow isn't able to make enough red blood cells. They are crowded out by the large numbers of abnormal white blood cells. A shortage of red blood cells is called anaemia. This can make you feel breathless and tired.

Low levels of platelets in the blood can cause bleeding or bruising. You may find that you bruise more easily than usual or with no obvious cause. You may also have bleeding from the gums or nose. More rarely people notice a fine rash of dark red spots (called purpura). Some people also have blood in their urine or stools.

The spleen is an organ on the left side of your body, just under your ribs. It can become swollen and larger than normal. This can cause discomfort or pain in your tummy (abdomen). Your doctor may be able to feel your enlarged spleen.

Diagram showing the position of the spleen

Some people gradually lose their appetite. This can be due to the swollen spleen pressing on the stomach.

Some people have sudden onsets of a high temperature (fever) and sweating. This can occur more often at night.

If you have a very high white blood cell count, the extra cells can clog the smallest blood vessels in the brain. This can cause headaches in some people.

Sometimes you may get aches in your bones. This is because there are leukaemia cells building up in the bone marrow, increasing pressure on nerves and causing pain.

Abnormal white blood cells collecting in the lymph glands may cause swelling.

Less common symptons

These symptoms may occur but are usually in the later stages of CML.

If you have a very high white blood cell count, the extra cells can clog the smallest blood vessels in the eyes. This may cause eye problems.

Some people get swollen joints due to a build up of body salts in the tissues.

Doctors call this priapism. It is a rare symptom. Priapism is an erection that won't go down and can become very painful. It is caused by the abnormally high number of white blood cells in the blood blocking up tiny blood vessels in the penis.

A priapism is an emergency. If you have persistent painful erection then you need medical attention. An erection that lasts too long can cause permanent damage to the penis.

Some people with advanced stages of CML have damage to their kidneys.

When to see your doctor

If you have any of these symptoms you must have them checked by your GP. But remember, they can be caused by other conditions. 

Most people with these symptoms will not have chronic myeloid leukaemia.

Last reviewed: 
14 Nov 2014
  • Essential haematology
    Hoffbrand and Moss, 6th Edition, 2011

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