Leukemia vs. lymphoma: Compare causes, symptoms, treatments, more

Leukemia vs. lymphoma causes | Prevalence | Symptoms | Diagnosis | Treatments | Risk factors | Prevention | FAQs | Resources

Leukemia vs. lymphoma: What’s the difference?

Leukemia and lymphoma are both types of blood cancer, so it’s easy to get them confused. While leukemia generally occurs in the bone marrow, lymphoma starts in the lymphatic system and affects the lymph nodes and lymph tissues. Leukemia is more common in children, whereas lymphoma is commonly diagnosed in older adults. In this article, we will discuss the differences between leukemia and lymphoma.

Causes

Leukemia

Leukemia is the result of a cell change within the bone marrow. When the normal cell mutates into a leukemia cell, it may grow and cause normal cells to stop developing. As the leukemia cells continue growing and dividing, they overtake the healthy cells in the body. As more and more healthy blood cells are replaced with leukemia cells, symptoms of leukemia start appearing. 

Types of leukemia

The main types of leukemia include:

• Acute lymphocytic leukemia (ALL): Most common form of leukemia in children
• Acute myeloid leukemia (AML): One of the most common adult leukemias
• Acute promyelocytic leukemia (APL): An aggressive form of AML where promyelocytes (a blood-forming cell) build up and reduce the number of other blood cells in the body
• Hairy cell leukemia (HCL): A rare form of leukemia that is caused by an overproduction of white blood cells called B lymphocytes
• Chronic lymphocytic leukemia (CLL): The most common chronic leukemia among adults
• Chronic myeloid leukemia (CML): A form of leukemia that is typically caused by a genetic abnormality in chromosome 22, called the Philadelphia chromosome
• Myeloproliferative neoplasms (MPN): A result of the bone marrow making too many blood cells, such as white blood cells, red blood cells, and platelets
• Systemic mastocytosis: The build-up of mast cells (a type of white blood cell) in the body

Lymphoma

Lymphoma is also the result of healthy cells mutating into cancer cells, although the exact causes of lymphoma are unknown. With lymphoma, a healthy lymphocyte (a type of white blood cell) undergoes a mutation that causes rapid cell production. Lymphoma usually begins in the B lymphocyte (B cells) and T lymphocytes (T cells) throughout the body.

Types of lymphoma

The main types of lymphoma include:

• Non-Hodgkin lymphoma (NHL): The most common type of lymphoma that usually starts in B or T cells
• Hodgkin lymphoma (HL): One of the most treatable types of cancer, usually starting in the B cells 

Prevalence

Leukemia

According to the Leukemia and Lymphoma Society, around 60,530 people were expected to be diagnosed with leukemia in 2020. In the U.S. alone, there are an estimated 376,508 people in remission from leukemia. 

Lymphoma

The Leukemia and Lymphoma Society also states in 2020, around 8,480 cases of Hodgkin’s lymphoma (HL) and 77,240 cases of Non-Hodgkins (NHL) were expected to be diagnosed. 791,550 people in the U.S are estimated to be living in remission from lymphoma as of 2020.

Symptoms

Leukemia

Leukemia may cause the lymph nodes to become enlarged or swollen. Shortness of breath and fatigue are also common. Signs of infection may appear including fever, loss of appetite, and weakness. The skin may bruise easily, or a person may notice bleeding that can’t be explained. Frequent infections may also be a symptom of leukemia.

Lymphoma

Since lymphoma is a cancer of the lymphatic system, swollen lymph nodes are common. These lymph nodes may be in the neck, groin, armpit, chest, or stomach. Fatigue, fever, and loss of appetite are also common. Unintentional weight loss and night sweats may develop as the disease progresses.

Diagnosis

Leukemia

Leukemia may be diagnosed by a primary care doctor or specialist. A medical history and physical exam are often the first steps in the diagnosis process. Blood tests are done to look for any abnormal white blood cell counts, as well as abnormal red blood cell and platelet counts. A sample of bone marrow may be taken to look for leukemia cells in the bone marrow. For this, a long, thin needle is inserted into the hip to remove bone marrow fluid from your body. The fluid is then sent to a laboratory to be examined for abnormal cells.

Lymphoma

The first steps in diagnosing lymphoma involve a thorough medical history and physical exam. An oncologist will check for signs of swollen lymph nodes and/or swollen organs. If lymphoma is suspected, samples of the lymph nodes may be taken and sent to a laboratory for further testing. Blood tests to look at levels of blood cells will also be done. The healthcare provider may also order imaging including MRI, CT, or PET scan.

Treatments

Leukemia

The treatment for leukemia is dependent on several factors including age, type of leukemia, and stage of the cancer. 

Chemotherapy is the most common first-line form of treatment for most leukemias. During chemotherapy treatment, drugs are used to kill the leukemia cells throughout the body. A single drug or combination of several may be used for treatment. A doctor will determine the best drug to start with. Targeted drug therapy is also an option for some, in which the leukemia cells in the body are tested to determine whether a targeted drug can successfully kill the cancer cells.

Radiation therapy, the process of using high-energy waves to destroy cancer cells, is also a common treatment option for leukemia. This can help stop the spread of harmful cancer cells, but may also destroy healthy cells in the process. 

A bone marrow transplant (stem cell transplant) may be done to remove cancer-filled bone marrow and replace it with healthy bone marrow. Generally, this is done after cancer patients receive chemotherapy and/or radiation to kill most of the cancer cells in the bone marrow. The healthy bone marrow from the transplant helps replace the diseased bone marrow.

Immunotherapy is also a treatment option for leukemia, although not every person with leukemia is a candidate. 

Lymphoma

Lymphoma treatment is also dependent on the stage of cancer at diagnosis. For some lymphomas, the “watch-and-wait” approach may be tried to see whether the cancer continues to advance. Some forms of lymphoma are very slow-growing and can be watched for several years without changes. Your oncologist will monitor the disease with routine physical exams and bloodwork to decide whether the disease or stable or needs further treatment.

Chemotherapy is usually the first-line treatment for most lymphomas. Drugs are administered either orally or through an IV to stop cell growth and destroy the harmful cancer cells. Radiation may also be used to damage the DNA of the harmful cancer cells. 

A bone marrow transplant may be used to replace the diseased bone marrow with healthy bone marrow. This new bone marrow helps the body begin the process of forming new red and white blood cells and platelets. The side effects of bone marrow transplants are harsh, so it’s not always a treatment option for everyone. 

Immunotherapy is also an option. Some people with active cancer, as well as those in remission, may be eligible to participate in clinical trials to try new and developing cancer treatments.

Risk factors

Leukemia

Some people have a higher risk of developing leukemia than others. Exposure to radiation and other nuclear toxins may increase the risk of developing leukemia. Being a smoker can also increase your risk. Some cancers and exposure to radiation or chemotherapy can lead to a higher chance of developing leukemia later on.

Having a family history of chronic lymphocytic leukemia (CLL), especially in a parent, child, or blood sibling, puts you at greater risk for developing CLL yourself. According to the Genetic and Rare Diseases Information Center, about 10% of people with CLL have a family history of the condition.

Myelodysplastic syndrome (MDS) is a group of bone marrow disorders that affect the way blood cells develop. MDS causes the development of abnormal blood and bone marrow cells. When severe, MDS can lead to leukemia. 

Lymphoma

Older age is one of the top risk factors for Non-Hodgkin lymphoma (NHL), with the majority of cases being diagnosed in people over the age of 60. Having a family history of NHL in a first-degree relative also increases the risk of NHL. Although more research is needed, exposure to some weed and insect-killing chemicals can increase the risk of NHL. Other known risk factors include radiation exposure, immune system dysfunction, and some autoimmune conditions.

Risk factors of Hodgkin’s lymphoma (HL) include having a history of mononucleosis. HL is more common in early and late adulthood and develops in males more often than in females. Having a family member that has had HL also increases your risk. A weakened immune system is another known risk factor.

Prevention

Leukemia

Being breastfed as a child has been shown to reduce the risk of developing leukemia. Limiting radiation exposure can also lower the risk of leukemia. Avoiding exposure to smoke and toxins may also put you at a lower risk. Maintaining a healthy weight and lifestyle may help lower the risk of cancer. 

Lymphoma

Preventing lymphoma relies on reducing certain risk factors. Since radiation exposure is a risk factor for lymphoma, it’s important to avoid as much exposure as possible. Some research suggests that being overweight or obese may increase the risk of developing NHL, so maintaining a healthy weight may reduce the risk of NHL. 

RELATED: 9 things you can do to prevent cancer

When to see a doctor for leukemia or lymphoma

If you have any symptoms of leukemia or lymphoma, you should visit a healthcare provider immediately. The symptoms of leukemia and lymphoma mimic several other conditions making it somewhat difficult to diagnose. The good news is that bloodwork is usually a first-line diagnostic test for most conditions and can pick up signs of blood cell abnormalities that may be present in both leukemia and lymphoma.

Frequently asked questions about leukemia and lymphoma

What is the difference between leukemia and lymphoma?

Leukemia is a blood cancer that develops in the bone marrow and blood. Lymphoma is also a blood cancer, but generally affects the lymphatic system, including the lymph nodes and lymph tissues.

Can leukemia turn into lymphoma?

Although rare, a complication known as Richter’s syndrome may occur in some people. Richter’s syndrome develops when chronic lymphocytic leukemia or small lymphocytic leukemia suddenly develops into a form of large cell lymphoma.

Which is more aggressive: leukemia or lymphoma?

The survival rate for lymphoma is higher than leukemia. According to the Leukemia and Lymphoma Society, the 5-year survival rate of all leukemias combined is 65.8 percent. The 5-year survival rate for Hodgkin’s lymphoma was 88.5% between 2009 and 2015.

What is the most common treatment for both lymphoma and leukemia?

Chemotherapy is the most common treatment for both lymphoma and leukemia. 

Resources

• Watch and wait, Leukemia & Lymphoma Society 
• Stem cell transplantation, Leukemia & Lymphoma Society
• Lymphoma, National Cancer Institute
• Facts and statistics, Leukemia & Lymphoma Society
• Risk factors for leukemia, Memorial Sloan Kettering Cancer Center
• Chronic lymphocytic leukemia, Genetic and Rare Diseases Information Center
• Leukemia prevention, Leukemia Foundation