Acute leukemia starts with development of symptoms within a few days to weeks, sometimes months.
The symptoms are often due to bone marrow failure:
- anemia symptoms
- infections due to granulocytopenia
- tendency for bleeding due to thrombocytopenia
- disturbance of coagulation system
In addition, the patient often has B symptoms:
- weight loss
- recurring fever
- night sweats
For the clinical examination of patients with acute lymphatic leukemia and acute myeloid leukemia M4 (myelomonocyte leukemia), there are often enlarged lymph nodes and hepatosplenomegaly. Leukemic infiltrates in gums are not uncommon with acute myeloid leukemia M4.
Some patients have petechia and sometimes ecchymoses. Patients with serious neutropenia (granulocytes under 0.5 x 109/l) can sometimes develop life-threatening systemic bacterial infections already before the diagnosis is made.
A rare subgroup of acute myeloid leukemia, hypergranular promyelocyte leukemia (M3), is clinically characterized by a great propensity to develop decompensated disseminated intravascular coagulation (DIC) with a large risk for bleeding and thrombosis.
Chronic leukemia is more insidious in its debut.
For chronic myeloid leukemia, there is often moderate or prominent splenomegaly, but rarely or never lymph node tumors.
For chronic lymphatic leukemia, there is often moderate local or generalized lymph node tumors and light to moderate splenomegaly.