2. Anemia and pallor
As noted above, acute lymphocytic leukemia not only affects lymphocytes but may also cause a reduction in other cell lines, including erythrocytes (red blood cells). As such, these patients have diluted blood that does not contain as much hemoglobin as it should. This reduction in hemoglobin level is called anemia, and one of the most frequent signs is pallor. Hemoglobin is what gives its natural red pigment to our blood, especially when it is fully oxygenated. Thus, insufficient hemoglobin in the blood leads to a change of color in the blood and the skin.