Leukemia has a rapid or slow onset, and most childhood and adolescent patients have a rapid onset. The common first symptoms include fever, progressive anemia, significant bleeding tendency, or bone and joint pain. The slow onset of the disease is mostly seen in elderly and some young patients, with progressive disease. Most of these patients have progressive fatigue, pallor, shortness of breath after exertion, lack of appetite, weight loss or unexplained fever as the first symptoms. In addition, a few patients can have convulsions, blindness, toothache, gingival swelling, pericardial effusion, and bilateral lower extremity paraplegia as the first symptoms of onset.
Among these, fever is one of the most common symptoms of leukemia, with more than half of patients starting with fever, which can be low- or high-grade, and can occur at different stages of the disease with varying degrees of fever and fever patterns. The disease itself can present with tumor fever, but high fever often suggests secondary infection. Infections can occur anywhere in the body, with pharyngitis, stomatitis, and perianal inflammation being the most common, and pneumonia, tonsillitis, gingivitis, and perianal abscesses are also more common. Ear inflammation, enteritis, carbuncles, pyelonephritis, etc. can also be seen, and sepsis and septicemia can occur in severe infections, which is one of the main causes of death. The pathogens of the infection are bacteria, and in the early stages of the disease, Gram-positive cocci are predominant. Viral infections are less common but often more dangerous, and cytomegalovirus, measles or varicella virus infections are easily complicated by pneumonia and must be noted.
And fever in leukemia is often accompanied by bleeding (gum bleeding, mucosal bleeding, etc.).