Easy bruising, bleeding gums and a sore throat that antibiotics cannot clear can look like a common infection, yet they can also point to leukaemia. Acute promyelocytic leukaemia (APL), a rare form of acute myeloid leukaemia, is one example.

A 2013 case series, 'Tonsillitis with Acute Myeloid Leukemia: A Case Series for Caution', notes that tonsillitis is commonly treated with antibiotics and anti-inflammatory drugs without further investigation. The authors describe tonsillitis as a rare first presentation of leukaemia.

Why Leukaemia Is Easy To Miss

The Mayo Clinic says leukaemia symptoms are often vague and can resemble flu or other common illnesses. They include persistent fatigue, frequent infections, easy bleeding or bruising, night sweats and unexplained weight loss.

Blood cancer symptom guidance adds that low platelets can cause bleeding gums, nosebleeds, heavy periods and tiny red spots called petechiae. A low white blood cell count can increase the risk of infections, which may cause symptoms such as a sore throat.

A separate case report described a young adult with non-resolving acute exudative tonsillitis later diagnosed as T-cell acute lymphoblastic leukaemia. Its authors stress the need to spot red flags in common symptoms to prevent delayed diagnosis.

Rowan Bland's Delayed Diagnosis

Rowan Bland, 28, felt run down and developed a sore throat in February 2025. Her GP diagnosed tonsillitis, but antibiotics did not help, and she began to get random bruises, bleeding gums and blood blisters in her mouth.

She returned to her GP several times as she developed red cluster rashes, dizziness, extreme fatigue, heavy periods, night sweats and significant weight loss. Her sore throat became so severe that she struggled to eat.

Rowan expected it to be glandular fever, saying unspecified illness in people her age 'kind of tracks'. After about a month, she asked for a blood test, and two hours later her GP told her to go straight to A&E.

Read more

She recalled the GP saying: 'I'm going to warn you, but I'm pretty sure this is leukemia.' She was told the hospital was waiting and she should go immediately.

Treatment and Recovery

Rowan, who was 27 at diagnosis, was transferred to the Beatson West of Scotland Cancer Centre in Glasgow. A bone marrow biopsy confirmed APL, and her blood counts were so low that she needed blood and platelet transfusions.

Doctors told her she was seriously ill, but that APL was highly treatable. She spent six to seven weeks in hospital receiving intravenous arsenic and ATRA tablets daily, and suffered complications including sepsis and blood clots.

A biopsy at the end of that treatment showed she was in remission. She then had six months of outpatient chemotherapy, finishing in November 2025, and a biopsy in January 2026 showed no evidence of the disease.

Urging Others to Push for Checks

Rowan once thought leukaemia was 'for babies' and that 'cancer is always like a lump'. She now urges young people not to assume serious illness is unlikely because of their age, and to push for blood tests.

She still has monthly blood tests and osteonecrosis affecting her bones. Even so, she took part in a 5K Race for Life, is training for a 10K and says: 'I would say I'm a completely different person [now].'

Colin Dyer, chief executive of Leukaemia Care, which supported Rowan during her hospital stay, said leukaemia can affect people of any age and its symptoms can be easily dismissed. He urged people to ask whether a blood test is appropriate.

Rowan said: 'I wouldn't have been so laissez-faire about getting checked out.' She added: 'I went undiagnosed for over a month and that could have ended very badly for me.'

Read more

Frequently Asked Questions

  • What are common symptoms of leukaemia?
    Common symptoms include easy bruising, bleeding gums, persistent fatigue, frequent infections, night sweats, and unexplained weight loss.
  • Why is leukaemia often missed in diagnosis?
    Leukaemia symptoms are often vague and can resemble flu or other common illnesses, making it easy to overlook.
  • What should you do if you suspect leukaemia?
    If you suspect leukaemia, it is important to push for a blood test and further medical evaluation.
  • Can leukaemia affect young people?
    Yes, leukaemia can affect people of any age, including young adults.