Leukemia is a cancer that affects the blood cells or bone marrow. Leukemia is a broad term for this type of cancer, as the condition varies depending on where the cancer originates, and whether it’s acute or chronic.
Acute myeloid leukemia (AML) is cancer that affects the myeloid cells, which are cells that give rise to certain types of white blood cells. Acute lymphocytic leukemia (ALL) is cancer that affects the lymphocytes, which are one of the primary white blood cells in the immune response.
Here is a closer look at each:
| AML | AML originates in myeloid cells, which are precursor cells that eventually become white blood cells called granulocytes and monocytes. While AML is a rare type of cancer, it is considered the most common type of leukemia diagnosed in adults. In 2020, there were roughly |
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| ALL | ALL originates in lymphocytes, which include specific white blood cells called T cells, B cells, and NK cells. Although ALL is rare, it is responsible for roughly According to the |
Although AML and ALL may seem similar, they are two different forms of leukemia, with similar but separate symptoms, diagnosis, treatment, and more.
Signs and symptoms of acute myeloid leukemia and acute lymphocytic leukemia are relatively similar, and are primarily caused by a reduction in the number of normal blood cells. Here is a chart of the most common symptoms associated with AML vs. ALL:
| Symptom | AML | ALL |
| abdominal swelling | X | X |
| bleeding gums | X | X |
| bone pain | X | X |
| changes in awareness | X | |
| dizziness or lightheadedness | X | X |
| easy bruising | X | X |
| enlarged lymph nodes | X | X |
| excessive bleeding | X | X |
| fatigue | X | X |
| feeling cold | X | X |
| fever | X | X |
| frequent nosebleeds | X | X |
| headaches | X | |
| heavy periods | X | X |
| joint pain | X | X |
| loss of appetite | X | X |
| night sweats | X | X |
| pale skin | X | X |
| shortness of breath | X | X |
| swollen thymus | X | |
| weakness | X | X |
| weight loss | X | X |
While almost all of these symptoms can appear with both conditions, only ALL is associated with swelling of the thymus, which is an organ that sits near the breastbone and trachea. When ALL causes the thymus to swell, it can cause symptoms like swelling in the face, neck, or upper torso; headaches; dizziness; and even changes in consciousness.
Both acute myeloid leukemia and acute lymphocytic leukemia can be diagnosed using similar tests that analyze the blood, bone marrow, and genes, such as the following:
- Blood tests. A complete blood count (CBC) measures the levels of red blood cells, white blood cells, and platelets. A peripheral blood smear is a follow-up test to a CBC which examines abnormalities within specific blood cells.
- Bone marrow tests. A bone marrow aspiration removes a sample of bone marrow fluid to analyze cells within the bone marrow. A bone marrow biopsy removes a sample of bone with marrow in order to analyze the cells.
- Genetic tests. A cytogenetic analysis, also known as karyotyping, is used to determine chromosomal abnormalities within specific cancer cells. A fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR) test can also be used to further examine cancer cells.
Although the diagnostic testing process for AML and ALL is similar, the conditions are diagnosed separately based on the following results:
- AML is diagnosed when there are leukemic blast cells present within the bone marrow at a concentration of 20 percent or more. However, even if the concentration of leukemic blast cells is lower than 20 percent, certain chromosomal features and antigens can confirm the diagnosis.
- ALL is diagnosed when there are leukemic blast cells related to the lymphoid line of cells at a concentration of at least 20 percent in the bone marrow. Like AML, certain genetic changes can help solidify a diagnosis of ALL even at lower concentrations within the bone marrow.
While treatment options for acute myeloid leukemia and acute lymphocytic leukemia can vary, most types of leukemia are treated using a similar combination of medications, radiation, and surgery.
Medications
Medication options for AML and ALL include chemotherapy, targeted drug therapy, and immunotherapy:
- Chemotherapy is a type of drug therapy that targets fast-growing cells like cancer cells to lower total cancer cells, reduce tumor size, and reduce the spread of cancer.
Targeted drug therapy only attacks the cancer cells and is often used when chemotherapy hasn’t been effective.- Immunotherapy is another type of drug therapy that helps the body’s immune system recognize and destroy cancer cells.
Medications used for leukemia treatment can be used either alone or in combination with other treatment options, depending on how the cancer is responding to treatment.
Radiation
Radiation therapy is a treatment option that uses beams of concentrated, high-energy radiation to kill cancer cells. Radiation therapy is not often the first line of therapy for AML or ALL. However, there are a few situations in which radiation might be used for leukemia:
- when the leukemia has spread to the brain, spinal fluid, or testicles
- when the person is receiving a bone marrow or stem cell transplant
- when a specific bone is causing pain and has not responded to chemotherapy
Procedures
Since AML and ALL are cancers that affect the blood and bone marrow, surgery is not usually a treatment option for these conditions, except in rare cases when the leukemia creates a tumor.
However, a stem cell transplant, or bone marrow transplant, is a procedure that involves transplanting blood-forming stem cells. In people with AML or ALL, this procedure can help replenish the cells within the bone marrow that may be lost when higher doses of chemotherapy or radiation are used.
Although acute myeloid leukemia and acute lymphocytic leukemia are considered rare forms of cancer, continued research of treatment options has greatly improved the outlook for these conditions.
According to the National Cancer Institute, the survival rates for both AML and ALL are as follows:
- AML has a relative 5-year survival rate of
29.5 percent based on data from 2011 to 2017, which means that almost 1/3 of people diagnosed with AML survive 5 years or longer after diagnosis. - ALL has a relative 5-year survival rate of
69.9 percent based on data from 2011 to 2017, which means that over 3/5 of people diagnosed with ALL survive 5 years or longer after diagnosis.
Everyone’s situation is different when it comes to cancer, and relative survival rates for each type of cancer are only an estimate. In the past decade, scientists have continued to research, produce, and test new treatment options for leukemia, many of which have greatly helped improve survival rates.
If you or someone you love has been diagnosed with acute myeloid leukemia or acute lymphocytic leukemia, there are resources that can offer hope and support: Consider checking out this directory from the Leukemia & Lymphoma Society, which includes national and international resources for people diagnosed with leukemia.
While acute myeloid leukemia and acute lymphocytic leukemia primarily differ in the types of blood cells they affect, they often appear similar in their symptoms, diagnosis, and treatment. Symptoms of both AML and ALL can also accompany other health conditions, so undergoing the right diagnostic testing is an important part of receiving prompt treatment.
With the right care team and the right treatment for your condition, you can greatly improve your overall quality of life with leukemia.