Is there a connection?

If you have leukemia and experience symptoms such as extreme fatigue, dizziness, or paleness, you may also have anemia. Anemia is a condition in which you have unusually low levels of red blood cells. Here’s more about the link between leukemia and anemia.

Bone marrow is a spongy material found in the middle of some of your bones. It contains stem cells, which develop into blood cells. Leukemia occurs when cancerous blood cells form in your blood marrow and crowd out healthy blood cells.

The type of blood cells that are involved determines the type of leukemia. Some types of leukemia are acute and progress quickly. Others are chronic and grow slowly.

The most common type of anemia people experience is iron-deficiency anemia. Low iron levels in the body can cause this. Aplastic anemia is a severe form of anemia that can occur due to exposure to:

  • a wide variety of drugs and chemicals
  • ionizing radiation
  • some viruses
  • an autoimmune disorder

It may also be linked to leukemia and cancer treatments.

Anemia can cause one or more of these symptoms:

  • fatigue
  • shortness of breath
  • dizziness
  • lightheadedness
  • a fast or irregular heart rate
  • pale skin
  • frequent infections
  • easy bruising
  • nosebleeds
  • bleeding gums
  • headaches
  • cuts that bleed excessively

Your body may not have enough red blood cells for a number of reasons. Your body may not make enough to begin with or even destroy the red blood cells that you do have. You can also lose red blood cells more quickly when you’re bleeding, whether it’s due to injury or menstruation.

If you have leukemia, both the disease itself and the treatments for it may cause you to develop anemia.

Cancer treatments

Chemotherapy, radiation, and some drugs doctors use to treat leukemia may cause aplastic anemia. This is because some cancer therapies prevent bone marrow from making new, healthy blood cells. White blood cell counts drop first, then platelet counts, and finally, red blood cell counts. Anemia due to cancer treatments may be reversible after treatment ends or it may last for several weeks.


Leukemia itself can also cause anemia. As leukemia blood cells multiply rapidly, little room is left for normal red blood cells to develop. If your red blood cell counts drop too low, anemia can occur.

Cancer treatments may cause a decreased appetite, nausea, and vomiting. This often makes it difficult to eat a nutritious, iron-rich diet. This may lead to iron-deficiency anemia.

If your doctor thinks you have anemia, they’ll order blood tests to check your blood cell levels and platelet levels. They may also order a bone marrow biopsy. During this procedure, a small sample of bone marrow is removed from a large bone, such as your hipbone. The sample is examined to confirm an anemia diagnosis.

Learn more: 7 important symptoms of leukemia in children »

Anemia treatments depend on the severity of your symptoms and the cause of your anemia.

If chemotherapy is causing your anemia, your doctor may prescribe injectable drugs, such as Epogen or Aranesp. These drugs tell your bone marrow to produce more red blood cells. They also have the potential to cause serious side effects, such as blood clots or increased risk of death. As a result, you should use the lowest dose possible for only as long as it takes to regulate your red blood cell levels.

Your doctor may recommend that you take iron supplements to treat iron-deficiency anemia.

If anemia occurs due to blood loss, your doctor will need to determine the cause and treat it. Because blood loss often occurs in the gastrointestinal tract, your doctor may recommend a colonoscopy and an endoscopy to view your stomach and intestines.

A blood transfusion is sometimes necessary to treat acute anemia. A transfusion alone may not be enough to control anemia in the long term.

According to Johns Hopkins Medicine, physician-scientists have discovered a chemotherapy drug called cyclophosphamide that helps treat aplastic anemia without harming blood and bone marrow-forming stem cells. Other treatments for aplastic anemia include blood transfusions, drug therapies, and bone marrow transplants.

If you think you have anemia, you should consult your doctor. They’ll review your symptoms and order the necessary tests to make a diagnosis. Don’t attempt to self-diagnose or self-treat anemia, especially if you have leukemia or any other medical condition. With treatment, anemia is manageable or curable. It may cause serious symptoms if you don’t get treatment for it.

If you have anemia, you can expect to have symptoms such as fatigue and weakness until your blood cell counts improve. The symptoms often improve rapidly once treatment starts. In the meantime, doing the following can help you cope:

  • Listen to your body’s signals, and rest when you’re tired or not feeling well.
  • Stick to a regular sleep schedule.
  • Ask for help with meals and household chores.
  • Eat a healthy, nutrient-rich diet, including iron-rich eggs, red meat, and liver.
  • Avoid activities that can increase your bleeding risk.

If you don’t experience relief with treatment or you have shortness of breath at rest, chest pain, or faintness, you should seek immediate medical attention.

If you have leukemia and develop anemia, your doctor will work with you to relieve your symptoms. Many treatment options can reduce anemia side effects during cancer treatment. The earlier you seek treatment, the less likely you are to develop serious complications.

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