Cancer that starts in the blood or in the tissues that make up blood is called leukemia. There are many types of leukemia, and symptoms and treatment can vary depending on the type.
Chronic myeloid leukemia (CML), also called chronic myeloid leukemia, is a cancer of the white blood cells. Immature white blood cells multiply very quickly, displacing other types of necessary blood cells.
CML symptoms occur because the cancer cells replace normal, healthy blood cells, such as red blood cells, platelets, and healthy white blood cells.
Symptoms of CML can be similar to other conditions, so it’s important to get evaluated to see if they persist over time.
Some symptoms are:
- Weight loss
When the disease starts, you may not have symptoms or they can be very mild. Your symptoms can be so general that at first you don’t see them as something to look out for, such as a fever or easy fatigue.
The “chronic” aspect of CML means that it is usually a slowly growing cancer so symptoms may slowly increase. However, there are times when a more aggressive, acute form of leukemia can develop.
Many people with CML are diagnosed as the result of blood tests done for regular checkups or other problems.
As the number of cancer cells in the blood increases and the disease progresses, symptoms may become more noticeable and severe. This is known as the accelerated or blastic phase.
For more information on how CML affects the body, see this article.
Fatigue is different from just being tired. It’s a severe lack of energy that no amount of sleep can fix.
Fatigue with CML does not improve or goes away over time and can affect your ability to participate in everyday activities. For example, you may be exhausted getting dressed in the morning or doing an errand that you used to do.
This fatigue typically occurs due to anemia. Anemia is a lack of red blood cells. Anemia occurs in CML because the cancerous white blood cells have replaced the healthy red blood cells. Without enough red blood cells, oxygen will not move efficiently around the body, leading to fatigue or weakness.
Shortness of breath, especially with everyday activities, is another symptom caused by anemia. The severity of the anemia depends on your hemoglobin level.
When your organs are not getting enough oxygen, your lungs have to breathe harder. A sign that your breathlessness can be severe is when it occurs while doing everyday tasks, such as speaking or doing light housework.
In CML, the cancer cells often crowd out the platelets in your blood. Without enough platelets, you bruise and bleed more easily. For example, when you brush your teeth, you may experience bleeding gums or recurrent nosebleeds.
Sometimes people with CML have too many platelets. However, because platelets are not healthy, they will not work as they should and can still cause easy bruising and bleeding.
An enlarged spleen or splenomegaly can be another symptom of CML. This is because cancer cells accumulate in the spleen.
You may have pain in the upper left side of your stomach or feel full after eating only a little. If you are very slim, you may even be able to see a bulge from a swollen spleen.
If your spleen grows too large, it can interfere with blood flow to the organ and eventually lead to anemia. Sometimes the enlarged spleen can also be linked to a hypermetabolic state, in which your body uses more energy than usual at rest. This deprives the body of sufficient and necessary nutrients, leading to other symptoms such as weight loss, fatigue, and muscle wasting.
An enlarged spleen can make you feel full if you haven’t eaten much and ultimately not even very hungry. Over time, this can lead to weight loss that you are not even aware of.
You can also lose weight because your body is in a hypermetabolic state, so it burns a lot of energy (also called calories). Because cancer cells divide quickly, they also use energy.
Fever and night sweats are called “B symptoms”. They can sometimes appear as part of the cancer process due to high markers of inflammation in the blood.
A fever can be caused by an infection if you have CML. It is more common in the accelerated blast phase. Your body cannot fight infection as well as it normally can because normal, healthy white blood cells have been replaced with cancerous blood cells.
Another cause of fever in CML is the hypermetabolic condition caused by an enlarged spleen. When your body’s metabolism increases, it can increase your body temperature as well.
While it’s not always clear what causes night sweats in cancer, it may be related to the body’s hypermetabolic state. This can lead to a high temperature or a fever, which makes the body sweat more than usual. Night sweats usually come with other symptoms and aren’t the only clues that you have cancer.
Bone pain can sometimes occur with CML. This happens when the cancer cells spread from the bone marrow cavity to the bone surface or joint.
Bone pain can be sharp or a dull ache, and there may be swelling where the pain is localized. As more cancer spreads to the bones, the pain may become more constant.
CML has a variety of symptoms that can appear very general in the early stages. As the cancer cells multiply and make more bone marrow, the symptoms can get more severe and you may notice more of them.
Since fatigue, weight loss, and anemia can be symptoms of many other conditions, speak to a doctor if you experience symptoms that are unusual for you. They can consider your medical history, do a physical exam, and order any tests that can help with the diagnosis.