Acute vs. chronic leukemia: What to know

As well as white blood cell function, other cells, such as red blood cells, and platelets are also affected by both leukemia types.

Although acute and chronic leukemia shares similar symptoms, there are a few differences between both cancers. For example, acute leukemia is typically more aggressive and life threatening than chronic leukemia.

Also, acute and chronic leukemia symptoms manifest differently for each person.  

Overview of acute leukemia

Acute leukemia is a fast-growing cancer of the white blood cells. Depending on the type of white cells affected, it divides into the following types:

• Acute myeloid leukemia (AML): This type has characteristics including the irregular growth of specialized white blood cells, red cells, and platelets in the bone marrow. It typically affects older adults but could occur in people ages 25–49.
• Acute lymphoid leukemia (ALL): This is a cancerous growth involving the lymphoid’s white cells in the bone marrow. Generally, it affects teenagers and young adults.

According to the National Cancer Institute (NCI), ALL affects approximately 107,620 people in the United States, while AML affects 69,700. 

Those with an acute leukemia diagnosis typically present with the following symptoms:

• fever
• lethargy
• anemia or low blood level
• joint and body aches
• weight loss
• easy bruising or bleeding. 

To aid diagnosis, doctors typically conduct the following laboratory investigations:

• complete blood count
• peripheral blood smear
• bone marrow biopsy and aspiration

A doctor can decide to conduct other tests depending on your symptoms.

Overview of chronic leukemia

Chronic leukemia is a slow-growing cancer of the white blood cells. It divides into the following types based on the kind of white cells affected:

• Chronic myeloid leukemia (CML): There’s an irregular increase of immature non-lymphocytic cells from the bone marrow to the blood. CML affects granulocyte cells, red cells, and platelets in the bone marrow. It typically affects older adults.
• Chronic lymphoid leukemia (CLL): This involves the cancerous growth of lymphoid white cells in the bone marrow. Generally, it affects adults and older adults.

The survival rate differs for each type of chronic leukemia. According to the National Cancer Institute, the five-year survival rate for CML is 70.4%, and CLL is 87.9%

People with chronic leukemia could present with the following symptoms:

• general weakness
• unexplained weight loss
• fever
• recurrent infections
• joint and bone pains
• enlarged lymph nodes

According to the NCI, in a few cases, individuals with CML may not present with symptoms.

Blood tests, such as complete blood count, peripheral blood smear, and bone marrow biopsy are essential for chronic leukemia diagnosis.

Key differences between acute and chronic leukemia

There are some fundamental differences between acute and chronic leukemia.

Cell growth rate

Acute leukemia is a rapidly growing blood cancer that results in the early migration of immature white blood cells into the blood.

In contrast, cancerous cells in chronic leukemia slowly migrate out of the bone marrow into the blood because it is a slow-growing blood cancer. This makes the chronic leukemia cancer cells appear more mature than those in acute leukemia. 

Symptom presentation

Acute leukemia symptoms typically appear suddenly, while chronic leukemia symptoms appear gradually. Because of this, early diagnosis and prompt treatment are more common in acute leukemia, which may positively influence the health outcome compared with chronic leukemia cases.

Acute leukemia treatment

There are various treatments for acute leukemia. Some common ones include:

• chemotherapy
• targeted therapy drugs
• stem cell transplant 
• radiation therapy 
• supportive care, including antibiotics and red blood cell and platelet transfusions

The treatment a doctor chooses will typically vary for each person, and they will base it on your specific test results. Also, a doctor may decide to use a combination of any of the available treatment options. For instance, the combination of chemotherapy and targeted therapy drugs is a common type of combination therapy.

Chronic leukemia treatment 

Chronic leukemia manifests differently, and this influences the choice of treatment.

The available forms of therapy for chronic leukemia, include:

• chemotherapy
• targeted therapy
• radiotherapy
• immunotherapy
• chemotherapy with bone marrow or stem cell transplant

Your healthcare team may suggest watchful waiting if you have a CLL diagnosis. Watchful waiting involves close observation of those who do not yet have any symptoms. When you become symptomatic, doctors typically begin treatment. Also, doctors and healthcare professionals may combine any of the treatment methods above, depending on symptoms.

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Summary

Acute leukemia is a fast-growing blood cancer, while chronic leukemia is slow-growing cancer. Therefore, acute leukemia symptoms appear suddenly, unlike chronic leukemia. Also, acute leukemia is typically more aggressive and requires early diagnosis and prompt treatment.

Acute leukemia symptoms may include unexplained tiredness, low blood level, joint and body aches, weight loss, and easy bruising or bleeding. Chronic leukemia symptoms typically include general weakness, unexplained weight loss, fever, recurrent infections, joint and bone pains, and enlarged lymph nodes.

Chemotherapy, targeted drug therapy, radiotherapy, and surgery are some of the available treatment methods for acute and chronic leukemia, and in some cases, a combination will apply.

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