Symptoms of Blood Cancer

The symptoms of hematologic malignancies (blood cancer) are usually generalized and vague, often including effects such as bruising, fevers, chills, and weight loss. If blood cancer is untreated, it can progress, usually with worsening effects, including organ failure.

Many types of blood cancer can be treated with approaches that include chemotherapy, radiation, and/or bone marrow transplant. While the treatments aren’t often curative, they can help prevent disease progression and prolong survival.

If you have blood cancer, it’s important that you learn how to recognize the symptoms and complications, as well as the side effects of your treatment, so you can get timely medical attention and treatment 

Types 

There are three main types of blood cancer: leukemia, lymphoma, and myeloma. These cancers cause abnormal production of leukocytes (white blood cells, WBCs). Each type of blood cancer affects specific subtypes of WBCs, often with an overproduction of certain WBC types, and inadequate levels of the other, noncancerous WBCs. 

With most hematologic malignancies, the overproduced WBCs are malignant (cancerous) and don’t provide the immunity that they are supposed to provide for the body. 

Leukemia 

WBCs are normally produced in the bone marrow. Leukemia is a type of blood cancer characterized by excess production of different types of WBC precursors (cells that would otherwise normally develop into healthy WBCs) in the bone marrow.

• Acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL) affect the lymphocytic WBCs (B cells and T cells).
• Acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) affect myeloid cells, which are precursors of red blood cells (RBCs), platelets, and all other WBCs besides lymphocytes.

Lymphoma

Lymphoma, which includes Hodgkin lymphoma and non-Hodgkin lymphoma, is a cancer of lymphocytes in the lymphatic vessels, lymph nodes, and the spleen.

Hodgkin lymphoma is a cancer of B-cell lymphocytes and it is diagnosed by the presence of Reed-Sternberg cells, which are seen with a microscopic examination. These cells are not present in non-Hodgkin lymphoma, which is also usually a cancer of B-cells, but can be a T-cell cancer.

Myeloma 

This blood cancer is characterized by excess plasma cells in bone marrow. Plasma cells are a type of B cell that produces antibodies, which are proteins that help fight infection. This type of cancer spreads in the bone marrow and damages bones.

Frequent Symptoms 

The effects of blood cancer are often related to several features of the condition. The cancerous WBCs don’t function as they should, and they may also invade areas of the body and/or produce inflammatory effects. 

There is usually also a deficiency of other WBCs that are not malignant, as well as anemia (a deficiency of RBCs). These cells are produced in the bone marrow and the effects of the cancer cells can interfere with their development.

Common symptoms of hematologic malignancies include: 

• Fever and chills, sometimes in the absence of an infection 
• Fatigue 
• Low energy 
• Bruising, often unexplained 
• Headaches 
• Generalized weakness
• Dizziness or lightheadedness
• Nausea and deceased appetite 
• Infections
• Weight loss
• Night sweats
• Bone and joint pain
• Swollen and/or tender lymph nodes in the neck, axilla (underarms), and/or groin area 
• Abdominal pain or discomfort 
• Shortness of breath, especially with physical exertion

You can have some or all of these symptoms with any type of blood cancer, but some symptoms can be more common with certain types. For example, lymph node swelling is more common with lymphoma than with other types of blood cancer, but it can occur with any type. 

Rare Symptoms 

Less common symptoms of blood cancer tend to occur along with the more common symptoms, and are rarely the only effects of blood cancer.

Less common effects of blood cancer include:

• Itchy skin or rash 
• Abdominal swelling 
• Bone pain
• Neuropathy: Nerve damage that can cause tingling, numbness, or weakness of the hands and feet 
• Amyloidosis: A type of protein deposit in the tissue of organs 
• Jaundice: Yellowing of the skin and eyes

These effects may occur as part of the blood cancer or due to complications of the cancer. 

Complications/Sub-Group Indications 

Advanced and untreated blood cancer can cause serious complications and can be life-threatening. Cancer cells and proteins can invade or deposit in organs throughout the body, resulting in organ failure.

Complications of hematologic malignancies include:

• Bone fractures as the cancer invades the bone marrow
• Hypercalcemia (high blood calcium), resulting from breakdown of bone
• Kidney failure due to diminished blood flow
• Kidney damage in myeloma due to damage from antibody deposits may manifest with foamy urine 
• Severe infections 
• Severe anemia 
• Confusion, changes in consciousness

Side Effects of Treatment 

The treatments used for managing blood cancer can have side effects, and you could experience the side effects of treatment as well as some effects of your cancer throughout your treatment. 

Common side effects of chemotherapy and radiation include:

• Leukopenia (low WBCs)
• Neutropenia (low neutrophils, a type of WBC)
• Hair loss
• Lymphedema (swelling of lymph nodes)
• Nausea, vomiting
• Blood clots
• Tumor lysis syndrome can cause weakness, fatigue, nausea, vomiting, and irritability.

Chimeric antigen receptor T-cell (CAR-T) therapy, a type of immunotherapy used to treat cancer, can cause fevers, hypotension (low blood pressure), bleeding and blood clotting problems, cognitive (thinking) impairment, and more.     

Bone marrow transplant may result in graft vs host disease or graft rejection, which can cause symptoms of nausea, vomiting, fevers, diarrhea, and abdominal pain.

When to See a Doctor/Go to the Hospital 

If you have worsening symptoms or new symptoms, you should get in touch with your medical team. Problems could be due to your cancer or a side effect of your treatment. 

Blood cancer can also lead to severe complications, potentially necessitating emergency medical care. You should know the signs of an emergency so you can seek prompt medical attention.

Signs that you should get urgent care include:

• Tachycardia (rapid heart rate)
• Hemoptysis (coughing up blood)
• Severe bleeding or bruising
• Leg or arm swelling, which can be a sign of deep vein thrombosis (DVT), a risk factor for pulmonary embolism (PE)
• Shortness of breath, which can be a sign of PE or infection 
• High fever 
• Persistent vomiting 
• Confusion 

Often, these issues need to be diagnosed so they can be adequately managed. They could be caused by an infection, a blood clot, or a variety of other serious issues. You would need to have your urgent situation treated, and you might also need adjustments in your blood cancer treatment. 

A Word From Verywell

A hematologic malignancy can be a very serious condition, but most blood cancers can be treated—resulting in a better outcome. It’s important that you get enough rest while you are being treated for blood cancer and that you understand which symptoms warrant prompt medical attention as you are undergoing treatment for your condition.