Leukemia is a cancer of the blood that begins in the bone marrow. It occurs when blood stem cells develop abnormally and then create white blood cells that don’t function correctly. Leukemia and its treatments can cause many symptoms, including easy bruising or bleeding. For some, this affects the gums, causing them to bleed much more easily than normal.

Several members of MyLeukemiaTeam have reported dealing with this symptom. “I was recently admitted to the hospital for bleeding gums,” one member wrote. “My gums started to bleed, and it became very difficult for the doctors to get it under control. It was a very trying time.”

Despite being a common symptom of leukemia, the sudden appearance of bleeding gums may be concerning or frightening. Here is what you need to know about gum bleeding with leukemia, including what causes it and how it can be managed. As with any symptom, talk to your health care provider or oncology team if you experience new or worsened bleeding from your gums.

What Causes Bloody Gums in Leukemia?

Several types of leukemia may cause a person to experience bloody gums. The side effects of treatments for leukemia, including chemotherapy and radiation therapy, may also include gum damage that can result in bleeding.

Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) can result in thrombocytopenia, or a decreased blood platelet count. This affects the blood’s ability to clot. As a result, a person may experience easier bleeding, including heavier-than-normal menstrual bleeding, nosebleeds, and gum bleeding.

Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is often linked with anemia (low red blood cell count), as well as abnormal bleeding caused by thrombocytopenia. As with ALL, this can cause the gums to bleed more easily than usual. AML itself may also spread to the gums, resulting in pain, swelling, and bleeding.

Chronic Leukemias

Chronic forms of leukemia can also cause a person to experience bleeding gums. This may result from thrombocytopenia or from thrombocytosis (increased blood platelet count) in chronic myeloid leukemia. Alongside bleeding gums, other oral symptoms of chronic leukemia can include gingivitis, oral lacerations (wounds), or loosened teeth.

Leukemia Treatments

Certain treatments for leukemia can cause lesions or sores to develop along the gastrointestinal tract, including the mouth and gums. These treatments include radiation therapy targeting the head or neck and certain types of chemotherapy and immunotherapy. The lesions may bleed when irritated, like when brushing the teeth.

Bleeding gums have developed for some MyLeukemiaTeam members as a result of treatment. One member taking ibrutinib (Imbruvica) said they noticed both positive and negative effects from the drug. “My counts are improving, but I have had side effects of more atrial fibrillations, bleeding gums, and back pain,” they wrote.

Managing Bloody Gums With Leukemia

If you’ve started to notice unusual bleeding around your gums with no clear cause, talk to your oncologist. They will be able to determine whether this symptom is caused by leukemia or another issue.

A dentist can also examine parts of your mouth you may not be able to see on your own, like the roof of your mouth or the insides of your cheeks. They’ll be able to determine the source of the bleeding and recommend ways to prevent worsening bloody gums.

Oral Health and Care With Leukemia

If you find your gums bleeding more easily, there are some steps you can take to help care for your teeth while minimizing bleeding. Your dentist may recommend using a soft-bristled toothbrush or foam swab, as well as brushing your teeth gently without scrubbing. They might also suggest temporarily pausing or reducing flossing to avoid irritating the gum tissue. A dentist may also advise trying certain gentle rinses, like salt water.

You may also need to be careful when undergoing dental procedures, as they could cause extra bleeding. One member wrote, “Be upfront with your dentist so they know what is going on. My dentist contacted my oncologist so they both had all the information, which allowed them to go ahead with the procedure while taking a few extra precautions.”

Dealing With Gum Bleeding

You can control active gum bleeding by applying firm pressure to the gums. The National Institutes of Health recommends using a gauze pad soaked in ice water to help stop bleeding. Contact your doctor as soon as possible if the bleeding continues or is heavier than normal.

Find Your Team

MyLeukemiaTeam is the social network for those living with leukemia and their loved ones. Here, you can ask questions, offer support and advice, and connect with others who understand life with leukemia.

Have you experienced bloody games with leukemia? Share your story, tips, or support in the comments below or by posting on MyLeukemiaTeam.