Symptoms and diagnosis of ALL

Symptoms of ALL

Many of the symptoms are caused by the change to normal blood cell production. You may not have all or any of the symptoms which include:

Tiredness (fatigue), shortness of breath: Not enough red blood cells (anaemia).
Recurrent infections or high temperatures/fever: Not enough white blood cells.
Blood in your urine, gums or stools (poo), unexplained bruising, tiny red spots on your skin: Not enough platelets in the blood.
Serious bleeding.
Aching bones and joints: Too many abnormal cells in your bone marrow.
Weight loss.
Loss of appetite.
Enlarged glands in your neck, underarm, stomach and groin.
Enlarged spleen, poor appetite, swollen tummy or tummy pain.
Sepsis - you may feel generally unwell, have a high or low temperature, or feel shivery.

All these symptoms can be caused by conditions other than cancer, but it’s important to go to the GP and get any unusual changes checked.

Recognising symptoms

Symptoms of ALL can be vague and include lethargy, lack of energy and general inability to do the things you normally do. If you have symptoms that are troubling you, or new symptoms appear, tell your doctor.

Can I be screened for ALL?

Testing for ALL when you have no symptoms is called screening. There is no leukaemia screening programme. This is because there have been no tests proven to help predict leukaemia. If you are worried about leukaemia, contact your family doctor (GP).

Diagnosing ALL

Your family doctor (GP) will talk to you about your symptoms and arrange blood tests, if needed. If your blood test is abnormal you will be referred to hospital for more tests. For example:

Physical examination: Listening to your chest, feeling your abdomen, asking questions about how you have been feeling recently.
Blood tests, such as a full blood count.
Bone marrow biopsy: Taking a sample of your bone marrow (and maybe bone) and looking at it under a microscope to see the number and type of cells in it.
Lumbar puncture: Taking a sample of the fluid that surrounds your brain and spinal cord using a needle in your lower back. The fluid will be checked for cancer cells.
Chromosome studies (cytogenetics): Tests on blood or bone marrow samples that look for genetic changes in your cells. For example, sometimes with ALL part of one chromosome is moved to another chromosome and a new one formed. This is called the Philadelphia chromosome and there are special treatments to target this.
Immunophenotyping: Checking for proteins or markers on the surface of the leukaemia cells to give more information about your type of ALL.

You may require other tests, such as a chest x-ray or lymph gland biopsy. However, not every person requires these.