Types of Leukemia

The types of leukemia are grouped by how quickly the disease develops and gets worse. Leukemia is either chronic (gets worse slowly) or acute (gets worse quickly):

Chronic leukemia — Early in the disease, the abnormal blood cells can still do their work, and people with chronic leukemia may not have any symptoms. Slowly, chronic leukemia gets worse. It causes symptoms as the number of leukemia cells in the blood rises.

Acute leukemia — The blood cells are very abnormal. They cannot carry out their normal work. The number of abnormal cells increases rapidly. Acute leukemia worsens quickly.

The types of leukemia are also grouped by the type of white blood cell that is affected. Leukemia can arise in lymphoid cells or myeloid cells. Leukemia that affects lymphoid cells is called lymphocytic leukemia. Leukemia that affects myeloid cells is called myeloid leukemia or myelogenous leukemia.

There are four common types of leukemia:

Chronic lymphocytic leukemia (chronic lymphoblastic leukemia, CLL) accounts for about 7,000 new cases of leukemia each year. Most often, people diagnosed with the disease are over age 55. It almost never affects children.

Leukemia, chronic lymphocytic: The most common form of leukemia in adults, in which the lymphocytes may look fairly normal but are not fully mature and do not deal effectively with infection. The malignant cells are found in the blood and bone marrow, collect in and enlarge the lymph nodes, and may crowd out other blood cells in the bone marrow, resulting in a shortage of red blood cells (producing anemia) and platelets (producing easy bruising and bleeding). Abbreviated CLL.

Chronic myeloid leukemia (chronic myelogenous leukemia, CML) accounts for about 4,400 new cases of leukemia each year. It affects mainly adults

Chronic myelogenous leukemia: A chronic malignant disease in which too many white blood cells belonging to the myeloid line of cells are made in the bone marrow. Early symptoms of this form of leukemia include fatigue and night sweats. The disease is due to the growth and evolution of an abnormal clone of cells containing a chromosome rearrangement known as the Philadelphia (or Ph) chromosome. Chronic myelogenous leukemia is commonly called CML. It is also known as chronic myelocytic leukemia and chronic granulocytic leukemia.

The bone marrow cells called blasts normally develop (mature) into several different types of blood cells that have specific jobs to do in the body. CML affects the blasts that are developing into white blood cells called granulocytes. These blasts do not mature normally and immature blast cells are found in the blood and bone marrow.

CML usually occurs in people who are middle-aged or older, although it also can occur in children. As a rule CML progresses slowly. In the first stages of CML, most people have no symptoms of cancer. When symptoms do appear, they may include a feeling of no energy, fever, lack of appetite, and night sweats. The spleen (in the right upper part of the abdomen) may be swollen and markedly enlarged..

Acute lymphocytic leukemia (acute lymphoblastic leukemia, ALL) accounts for about 3,800 new cases of leukemia each year. It is the most common type of leukemia in young children. It also affects adults.

Acute lymphoblastic leukemia: An acute (sudden onset), rapidly progressing form of leukemia that is characterized by the presence in the blood and bone marrow of large numbers of unusually immature white blood cells destined to become lymphocytes. Acute lymphoblastic leukemia is also called acute lymphocytic leukemia and is abbreviated ALL (spoken not as the word "all", but as the three letters A-L-L). ALL is the most common cancer occurring in children, representing almost 25% of cancer among children. There is a sharp peak in the incidence of ALL incidence among children ages 2 to 3. This peak is approximately fourfold greater than that for infants and is nearly 10-fold greater than that for youths who are 19 years old.

For unexplained reasons, the incidence of ALL is substantially higher for white children than for black children, with a nearly threefold higher incidence at 2 to 3 years of age for white children compared to black children. The incidence of ALL appears to be highest in Hispanic children.

Acute myeloid leukemia (acute myelogenous leukemia, AML) accounts for about 10,600 new cases of leukemia each year. It occurs in both adults and children.

Acute myeloid leukemia: A quickly progressive malignant disease in which there are too many immature blood-forming cells in the blood and bone marrow, the cells being specifically those destined to give rise to the granulocytes or monocytes, both types of white blood cells that fight infections. In AML, these blasts do not mature and so become too numerous. AML can occur in adults or children. Acute myeloid leukemia is abbreviated AML (pronounced A M L). It is also known as acute myelogenous leukemia or acute nonlymphocytic leukemia (ANLL).

The early signs of AML may be similar to the flu or other common diseases with fever, weakness and fatigue, loss of weight and appetite, and aches and pains in the bones or joints. Other signs of AML may include tiny red spots in the skin, easy bruising and bleeding, frequent minor infections, and poor healing of minor cuts.

First, blood tests are done to count the number of each of the different kinds of blood cells and see whether they are within normal ranges. In AML, the red blood cell levels may be low, causing anemia; platelet levels may be low, causing bleeding and bruising; and the white blood cell levels may be low, leading to infections

Acute myelogenous leukemia: Abbreviated AML. Also called acute myeloid leukemia or acute nonlymphocytic leukemia (ANLL). A quickly progressive malignant disease in which there are too many immature blood-forming cells in the blood and bone marrow, the cells being specifically those destined to give rise to the granulocytes or monocytes, both types of white blood cells that fight infections. In AML, these blasts do not mature and so become too numerous. AML can occur in adults or children.

A bone marrow biopsy or a bone marrow aspiration may be done if the results of the blood tests are abnormal. During a bone marrow biopsy, a hollow needle is inserted into the hip bone to remove a small amount of the marrow and bone for examination under a microscope. In a bone marrow aspirate, a small sample of liquid bone marrow is withdrawn through a syringe.

A lumbar puncture, or spinal tap, may be done to see if the disease has spread into the cerebrospinal fluid, which surrounds the central nervous system (CNS) -- the brain and spinal cord.

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