There eventually is enlargement of the lymph nodes, liver, and spleen. Common to all leukemias are the tendency to bleed and the resultant anemia and increased susceptibility to infection. The diagnosis of leukemia requires confirmation of leukemic cells in the bone marrow by bone marrow biopsy and aspiration.
River Phoenix's autopsy showed deadly levels of cocaine and morphine (heroin shows up as morphine, as it's metabolized by the body), Valium, marijuana and ephedrine. Ephedrine is the main ingredient found in crystal meth. Official cause of death was Acute multiple drug ingestion. River Phoenix was just 23 years old.
, Well over 13,000 movies by now. 1  Unless he was able to control his drug addictions, there wouldn't have been much of a future for River Phoenix. Hollywood was changing even then and it would have been much harder to insure him had he continued to have the substance abuse problems which ended his life.