Leukemia is a type of cancer in the body’s blood-forming tissues, such as the bone marrow and the lymphatic system. There are many types of leukemia, some more common in children and some more common in adults—acute myelogenous leukemia (AML) occurs in both children and adults. Treatments depend on the type you have, but can include Venclexta, EGFR mutation targeted therapy, chemo pill for chronic lymphocytic leukemia (CLL), and Gilteritinib for relapsed refractory AML. Relapsed refractory (RR) AML can also cause idh2 mutations which then require IDH inhibitors—as you can see, the type of treatment not only depends on the type of leukemia, but many additional factors as well. While treatments can be grueling, early detection of leukemia is very important. Here are 5 early warning signs of leukemia to watch out for:

1. Chronic fatigue/weakness

Fatigue is the most common symptom of leukemia and is described as extreme exhaustion that interrupts daily life and activities, leaving you feeling weak and with little energy that makes simple tasks challenging. This type of tiredness won’t go away with a good night’s rest or a nap, and it often occurs due to the development of anemia that results from bone marrow being unable to produce red blood cells efficiently, thus causing less oxygen to be carried around the body.

2. Swollen lymph nodes

Swollen lymph nodes are a common symptom with chronic lymphocytic leukemia (CLL). Bone marrow produces lymphocytes, a white blood cell that fights infection, but in those with CLL, these lymphocytes don’t develop into healthy cells, resulting in an increased risk of developing infections. With this, the lymphocytes also can collect in the lymph nodes and cause swelling.

3. Recurrent nosebleeds

The extra white blood cells that are produced take up a lot of space in the bone marrow, making it hard for the bone marrow to produce platelets. Platelets are cell fragments that form clots and stop or prevent bleeding, so without the production of them, nosebleeds may occur more frequently.

4. Red spots on skin

Red spots on the skin, known as petechiae, are a symptom of leukemia that are also due to the lack of platelets produced by bone marrow. The red spots are caused by tiny, broken blood vessels (capillaries) under the skin. Without the platelets, your body cannot create blood clots and seal off the broken vessels, thus resulting in red spots.

5. Bone pain or tenderness

Bone pain or tenderness often occurs in leukemia patients due to the accumulation of abnormal white blood cells and the inflammation that follows. The pain can be sharp or dull, depending on the location—oftentimes, pain occurs in the long bones of the arms and legs.