What is the most prominent physical sign of chronic myeloid leukemia?

Jun 20, 2025 Source: Cainiu Health

Dr. Liu Feng

Introduction

In general, there is no single most prominent sign of chronic myeloid leukemia, as symptoms may vary from person to person. Common signs include splenomegaly, sternal tenderness, pallor due to anemia, skin bruising, and enlarged lymph nodes. If any abnormalities are noticed, timely medical consultation is recommended. Most patients will present with significant splenomegaly, which can extend into the pelvic cavity in severe cases.

Generally, there is no single most prominent sign of chronic myeloid leukemia, as symptoms can vary from person to person. Common signs include splenomegaly (enlarged spleen), sternal tenderness, pallor (anemic appearance), skin bruising or petechiae, and swollen lymph nodes. If any abnormalities are noticed, timely medical consultation is recommended. Detailed explanations are as follows:

1. Splenomegaly: Most patients develop significant spleen enlargement. In severe cases, the spleen may extend into the pelvic cavity. A hard mass can be felt in the upper left abdomen, accompanied by a feeling of pressure or pain upon palpation. Some patients experience abdominal fullness and reduced appetite due to the spleen's impact on gastrointestinal function. This occurs due to abnormal proliferation and infiltration of leukemia cells within the spleen.

2. Sternal Tenderness: Significant pain upon pressing or tapping the middle to lower portion of the sternum is a relatively characteristic sign of chronic myeloid leukemia. The excessive proliferation of leukemia cells within the bone marrow increases pressure in the marrow cavity, stimulating the periosteal nerves and causing tenderness in the sternum.

3. Pallor: Patients may appear pale, with lighter-colored lips and nail beds, and conjunctiva of the eyelids lacking redness. This is often accompanied by symptoms such as fatigue, dizziness, and palpitations. These signs of anemia occur because leukemia cells suppress normal blood cell production in the bone marrow, reducing red blood cell formation and leading to tissue hypoxia.

4. Skin Bruising: Skin may show bruises (ecchymoses) of varying sizes, commonly found on the limbs and trunk. These bruises appear easily even after minor trauma and fade slowly. They result from a reduced platelet count or impaired platelet function, which leads to coagulation disorders and subcutaneous or mucosal bleeding.

5. Swollen Lymph Nodes: Some patients may develop enlarged superficial lymph nodes, such as those in the neck, armpits, and groin. These nodes are usually firm and movable in the early stages, with little or no tenderness. As the disease progresses, the lymph nodes may gradually enlarge, indicating infiltration of lymphoid tissues by leukemia cells.

If any of the above signs are observed, especially significant spleen enlargement or sternal tenderness, prompt medical attention should be sought for tests such as complete blood count and chromosome analysis. Regular physical examinations and attention to unusual bodily changes can aid in the early detection and treatment of chronic myeloid leukemia, helping to avoid treatment delays.

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