Acute vs Chronic Leukemia
Leukemia is a type of blood cell cancer. There are four types of leukemia; two types of acute leukemia and two types of chronic leukemia. The two acute leukemias are acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The two chronic leukemias are chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Most leukemias are initiated by specific genetic mutations, deletions or translocations. All these show similar symptoms and signs; however, they require different treatment methods. This article will discuss all four types of leukemia and the differences between them, highlighting their clinical features, causes, investigation and diagnosis, prognosis, and also the different treatment methods required for each.
Acute lymphoblastic leukemia (ALL) manifests as neoplastic proliferation of lymphoblasts (immature lymphocytes). WHO classification divides ALL into B lymphocytic leukemia and T lymphocytic leukemia. Immunologically ALL is classified as T cell ALL, B cell ALL, Null-cell ALL, and common ALL. Their symptoms and signs are due to marrow failure. Low hemoglobin, infections, bleeding, bone pain, joint inflammation, spleen enlargement, lymph node enlargement, thymus enlargement, and cranial nerve palsies are common features of ALL. Zoster, CMV, measles, and candidiasis are common infections seen in ALL patients. Preventing infections with prompt antibiotic therapy and vaccination, chemotherapy to induce remission, consolidate and maintain remission are important steps in managing ALL. Bone marrow transplantation also plays a major role in managing ALL.
Acute myeloid leukemia (AML) is a neoplastic proliferation derived from marrow myeloid elements. It is a very rapidly progressive malignancy. There are five types of AML. They are AML with genetic abnormalities, AML with multi-lineage dysplasia, AML myelodysplastic syndrome, AML of ambiguous lineage, and uncategorized AML. Anemia, infection, bleeding, disseminated intravascular coagulation, bone pain, cord compression, large liver, large spleen, lymph node enlargement, malaise, lethargy, and joint pain are common features of AML. Supportive care like blood transfusion, antibiotics, chemotherapy and bone marrow transplantation are the usual treatment methods.
Chronic myeloid leukemia (CML) is characterized by uncontrolled proliferation of myeloid cells. It accounts for 15% of leukemias. It is a myelo-proliferative disorder, having features common with these diseases. Weight loss, gout, fever, sweats, bleeding, and abdominal pain, anemia, large liver and spleen are common features. Philadelphia chromosome, which is a hybrid chromosome formed after a translocation of chromosome 9 to 22. Imatinib mesylate, hydroxyurea, and allogeneic transplantation are commonly used treatment methods.
Chronic lymphocytic leukemia (CLL) is a monoclonal proliferation of small lymphocytes. The patient is usually over 40 years old. Men are affected twice as often as women. CLL accounts for 25% of leukemias. It results in autoimmune hemolysis, infection and bone marrow failure. Radiotherapy, chemotherapy and supportive care are needed to treat CLL.
What is the difference between Acute and Chronic Leukemia?
• Acute leukemias are immature cell cancers while chronic leukemias are mature cell cancers.
• Acute leukemias are more common in young individuals while chronic leukemias are common in the older people.
• Each type of leukemia needs different treatment methods.