Symptoms of acute lymphoblastic leukaemia (ALL)

Symptoms of ALL can be similar to those caused by other illnesses. The symptoms are caused by too many abnormal white blood cells and not enough normal white cells, red cells and platelets. 

Symptoms of ALL might include one or more of the following:

  • feeling weak or tired
  • flu-like symptoms
  • a high temperature (fever)
  • picking up or not being able to shake off infections such as coughs and colds
  • bruising and bleeding easily
  • weight loss
  • swelling of your lymph nodes
  • pain in your bones or joints
  • breathlessness
  • feeling full in your tummy (abdomen)
  • looking pale or washed out

General weakness

You might feel weaker than normal. 

Feeling tired (fatigue)

You might feel more tired than normal, even if you're getting a good nights sleep.

High temperature (fever)

You might have a high temperature or feel feverish.

Frequent infections

You might pick up infections such as coughs and colds easily. Or you might find that the infections last a long time and are difficult to shake off.

This is because you don’t have enough healthy white blood cells to fight bacteria or viruses.

Bruising or bleeding easily

You might have:

  • nosebleeds
  • bleeding gums when you clean your teeth
  • very heavy periods
  • small dark red spots on your skin
  • blood in your wee (urine) or poo (stool)

You might find you are bruising more easily than normal.

Weight loss

You might lose weight even if you haven't changed your diet.

Swollen lymph nodes

Your lymph nodes (glands) might feel swollen when you touch them. You have lymph nodes in lots of places in your body. They might feel swollen in:

  • your neck
  • under your armpit
  • in your groin

Pain in your bones or joints

You might feel pain in your bones or joints. This might be a dull ache or more of a stabbing pain. It might be worse at different times of the day.

Too many abnormal white blood cells collecting in the bones, joints or lymph nodes may cause pain and swelling.

Feeling short of breath (breathlessness)

You might feel breathless when doing your normal day to day activities or from climbing a short flight of stairs. This could be because you do not have enough red blood cells. 

Feeling full in your tummy (abdomen)

You might have a feeling of fullness or discomfort in your tummy (abdomen). This can happen if your liver or spleen are swollen.

Pale skin

You might look paler or more 'washed out' than normal. 

Other symptoms

A type of leukaemia called T cell ALL can cause swollen lymph nodes in the centre of your chest. It might make the thymus gland in your upper chest bigger. The swollen nodes or thymus gland may press on the windpipe, causing breathlessness and coughing.

They can also press on the veins carrying blood from the head. This causes pressure in the blood vessels and makes the face, neck and arms swell and go red. This is called superior vena cava obstruction (SVCO).

Go to the accident and emergency (A&E) department at your nearest hospital if you have any of these symptoms. It can be a medical emergency.

When to see your doctor

You should get any of these symptoms checked by your GP. But remember, they can all be caused by other medical conditions. Most people with these symptoms don’t have leukaemia.

Last reviewed: 
18 May 2021
Next review due: 
18 May 2024
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    National Institute for Health and Care Excellence (NICE), June 2015. Last Updated January 2021

  • Scottish Referral Guidelines for Suspected Cancer
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  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

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