In leukaemia, the gums are hyperplastic and locally infiltrated with a large number of immature white blood cells, and are therefore mostly pale and some may also be dark red in colour. This is accompanied by a high degree of oedema of the gingival connective tissue, with gingival necrosis and ulceration often occurring on the surface due to leucocyte embolism. At the same time, patients may have systemic manifestations of leukaemia such as wasting, anaemia, enlarged lymph nodes and fever.