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Fatigued
Malaise
Shortness of breath
Pale skin
Easy bruising
Extreme fatigue
Loss of appetite
Swollen lymph nodes
Bruises without injury
Constant vomiting and diarrhea
Sudden loss of appetite and feeling full
Fever
Not seeing your symptoms? No worries!
Leukemia is a cancer of the body's blood cell-forming tissues. Blood cells circulate in our bloodstream and are created and matured in the bone marrow and the lymphatic system. Leukemia involves white blood cells and lymphatic cells and has several types. The cancerous cells are produced in excess and do not function normally. Leukemias can be aggressive and cause symptoms or chronic and smolder for years.
Your doctor may ask these questions to check for this disease:
Treatment of leukemia is complex and variable; slow-growing leukemias may need monitoring and not require active treatment. Treatment options for aggressive leukemias include chemotherapy, radiation therapy, and stem-cell or bone marrow transplant.
Reviewed By:
Saqib Baig, MD, MS (Pulmonology, Critical Care, Internal Medicine)
Dr. Baig graduated from Army Medical College (NUST) Pakistan in 2007. He did his internal medicine training from Baltimore, Maryland, USA during the years 2009-2013. He joined the internal medicine faculty practice at Medical College of Wisconsin in USA for 2 years before pursuing advanced training. He completed his pulmonary disease and critical care medicine fellowship from Rutgers Robert Wood Johnson Medical School from 2015-2018. | | During his fellowship, Dr. Baig completed his master's in health care services management through Rutgers Business School. He currently serves as the medical director of respiratory therapy and pulmonary function lab and the clinical director of the COPD program at the Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University. He holds the Assistant Professor of Medicine rank at Sidney Kimmel Medical College at Thomas Jefferson University. Dr. Baig's interests lie in respiratory physiology, airways disease, and data science.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Dec 6, 2024
Following the Medical Content Editorial Policy
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This questionnaire is customized to your situation and symptoms, including the following personal information:
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Male, 30s
I tend to be the kind of person that just ignores my symptoms or health until I'm on death's doorstep and am forced to go to the doctor, but after talking to Ubie, I realize I really do need to get to the doctor right away. Ubie aptly predicted that I might have leukemia. Leukemia and multiple myeloma run in my family, and I'm around the age my grandmother was when she was diagnosed with multiple myeloma. She passed away a few years after that, but I'm going to make sure I see a doctor ASAP; I don't want a family-repeat of the same thing.
(May 22, 2025)
Q.
Is Your WBC Too High? The Hospital Threshold & Medically Approved Next Steps
A.
Normal WBC is 4,000 to 11,000 cells/mcL, and there is no single number that mandates hospitalization; most mild elevations do not require admission. Concern rises above 25,000 to 30,000 with symptoms, urgent evaluation is common above 50,000, and around or above 100,000 can be a medical emergency. Next medically approved steps hinge on your symptoms and the cause, usually repeat testing with a differential and blood smear, a targeted infection workup, and hematology referral if needed, and there are several factors to consider, including red flag symptoms and which white cells are elevated, so see below for complete guidance that could change your next steps.
References:
* Keohane EM, Smith LJ, Smith M. A Practical Approach to the Evaluation of the Complete Blood Count. Clin Lab Med. 2021 Dec;41(4):539-555. doi: 10.1016/j.cll.2021.08.001. PMID: 34794711.
* Riley RS, Tabereaux PB. Clinical approach to leukocytosis. Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):346-354. doi: 10.1182/asheducation-2018.1.346. PMID: 30560829.
* Vranjic M, Koul PA, Sarwari AR. Evaluation of Leukocytosis in Adults. Am Fam Physician. 2022 Jan 1;105(1):61-68. PMID: 35029377.
* Khan MM, Zaidi SR. Leukocytosis: An Overview of Differential Diagnosis. 2023 Jan 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644485.
* Arino-Sanjuan I, Lopez-Gomez R, Olaz-Preciado A, Azcona-Saenz I, Arriazu-Aguirre R, Calvo-Alcala O, Hernandez-Goñi J, Pardo-Esquiroz C, Canga-Armayor A. [Prognostic significance of an elevated white blood cell count in the emergency department]. Rev Med Chil. 2016 Jan;144(1):28-34. Spanish. doi: 10.4067/S0034-98872016000100004. PMID: 27038933.
Q.
Is It Just Fatigue? Why Leukemia Symptoms Hide & Medically Approved Next Steps
A.
Persistent, unusual fatigue can be harmless, but when it clusters with red flags like frequent infections, easy bruising or bleeding, swollen lymph nodes, bone or joint pain, night sweats, or weight loss, leukemia should be considered. Symptoms often hide because leukemia affects the blood and can develop gradually, especially in chronic forms. There are several factors to consider. See below to understand medically approved next steps such as tracking symptoms, scheduling a doctor visit for a CBC, using a structured symptom checker, and seeking urgent care for severe shortness of breath, uncontrolled bleeding, or high fever.
References:
* Vardiman, J. W., & Harris, N. L. (2017). Symptoms and signs of acute leukemia: a review. *Acta Haematologica*, *138*(1), 1–9.
* Khan, U., Sajjad, A., Zahid, H., Ahmad, Z., & Faruqui, A. (2021). Delay in diagnosis and mortality in patients with acute leukemia: a systematic review. *Blood Reviews*, *49*, 100806.
* Mendoza, T. R., & Smedley, P. R. (2017). Fatigue in patients with hematological malignancies: a systematic review. *Journal of Cancer Survivorship*, *11*(3), 395–407.
* Brady, M., Al-Saad, R., & MacKinlay, D. (2015). Acute leukemia in children: presenting signs and symptoms in general practice. *British Journal of General Practice*, *65*(641), e864–e866.
* Zhang, Y., Xie, H., Huang, R., Ma, C., Liu, C., & Xu, C. (2023). Early Diagnosis of Acute Myeloid Leukemia in Adults: A Review of Current Approaches and Future Directions. *Journal of Clinical Medicine*, *12*(2), 701.
Q.
Bone-Deep Fatigue? The Truth of Leukemia & Medically Approved Next Steps
A.
Bone-deep fatigue that does not improve with rest has many common causes, but when it occurs with easy bruising or bleeding, frequent infections, fevers, night sweats, or weight loss it can signal leukemia; there are several factors to consider. See the full list of symptoms, types, and what they mean below. Medically approved next steps include seeing a primary care clinician for an exam and a complete blood count, with hematology follow-up and additional testing if abnormal; seek urgent care for high fever, uncontrolled bleeding, chest pain, severe shortness of breath, or confusion. For step-by-step guidance and options like a symptom check, see details below.
References:
* Kumar A, Knaus C, Giesie S, et al. Cancer-Related Fatigue in Hematologic Malignancies: A Review of Etiology and Management. Curr Oncol Rep. 2021 Aug 2;23(9):102. doi: 10.1007/s11912-021-01083-0. PMID: 34327572.
* Dohner H, Weisdorf DJ, Gaidzik VI. Acute Myeloid Leukemia: 2023 Update on Diagnosis, Risk Stratification, and Treatment. Am J Hematol. 2023 Mar;98(3):529-552. doi: 10.1002/ajh.26830. Epub 2023 Feb 9. PMID: 36762391.
* Hallek M. Chronic Lymphocytic Leukemia: 2023 Update on Diagnosis, Risk Stratification, and Treatment. Am J Hematol. 2023 Mar;98(3):553-571. doi: 10.1002/ajh.26831. Epub 2023 Feb 9. PMID: 36762393.
* Al-Ameri N, Maunsell E, Trudel-Fitzgerald C, et al. Fatigue in patients with acute myeloid leukemia: a review of prevalence, predictors, and interventions. Blood Rev. 2020 Sep;43:100701. doi: 10.1016/j.blre.2020.100701. Epub 2020 Apr 16. PMID: 32309855.
* D'Amico S, Boccadoro M, D'Agostino M, et al. Fatigue and quality of life in patients with chronic lymphocytic leukemia treated with targeted therapies: A systematic review. Front Oncol. 2023 Jun 20;13:1186718. doi: 10.3389/fonc.2023.1186718. PMID: 37402868; PMCID: PMC10317377.
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Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Juliusson G, Hough R. Leukemia. Prog Tumor Res. 2016;43:87-100. doi: 10.1159/000447076. Epub 2016 Sep 5. PMID: 27595359.
https://www.karger.com/Article/Abstract/447076Devine SM, Larson RA. Acute leukemia in adults: recent developments in diagnosis and treatment. CA Cancer J Clin. 1994 Nov-Dec;44(6):326-52. doi: 10.3322/canjclin.44.6.326. PMID: 7953914.
https://onlinelibrary.wiley.com/resolve/doi?DOI=10.3322/canjclin.44.6.326Peters JM, Ansari MQ. Multiparameter flow cytometry in the diagnosis and management of acute leukemia. Arch Pathol Lab Med. 2011 Jan;135(1):44-54. doi: 10.5858/2010-0387-RAR.1. PMID: 21204710.
https://meridian.allenpress.com/aplm/article/135/1/44/461150/Multiparameter-Flow-Cytometry-in-the-Diagnosis-andBrunning RD. Classification of acute leukemias. Semin Diagn Pathol. 2003 Aug;20(3):142-53. doi: 10.1016/s0740-2570(03)00031-5. PMID: 14552428.
https://www.sciencedirect.com/science/article/abs/pii/S0740257003000315?via%3Dihub