Leukemia vs. Lymphoma:
First Symptoms, Diagnosis & Treatment
What is leukemia? What is lymphoma? Read on learn the similarities and differences between the two, their common first symptoms, diagnoses, and treatments.
- Leukemia vs. Lymphoma: What's the difference?
- Main Types of Leukemia
- Main Types of Lymphoma
- Common First Symptoms of Leukemia vs. Lymphoma
- Diagnosis of Leukemia vs. Lymphoma
- Treatment of Leukemia vs. Lymphoma
- Leukemia Stories
- Lymphoma Stories
- Classical Hodgkin Lymphoma
- Nodular Lymphocyte Predominant Hodgkin Lymphoma
- Anaplastic Large Cell Lymphoma (ALCL)
- Chronic Lymphocytic Leukemia (CLL)/ Small Lymphocytic Lymphoma (SLL)
- Diffuse Large B-Cell Lymphoma (DLBCL)
- DLBCL and Burkitt Lymphoma
- Marginal Zone Lymphoma (MZL)
- Primary Mediastinal B-Cell Lymphoma (PMBCL)
- Waldenstrom Macroglobulinemia
- Other Cancer General Info Articles
Leukemia vs. Lymphoma: What’s the difference?
Dr. Timothy Fenske, one of the oncologists who frequently offers guidance to The Patient Story, says:
The short answer is leukemia means you have cancer cells circulating in the blood.
Lymphoma is when you have cancer in the cells in lymph nodes or other organs that are part of the blood system like the spleen.
There are, of course, exceptions. You can see lymphoma show up in just about any organ. Leukemia can present like tumors in the blood.
The most common scenario is that leukemia is circulating in the blood and there are detectable cancer cells in the blood. Whereas a straight lymphoma is when the cells aren’t so much detectable in the blood, but they’re in the lymph nodes. “
Leukemia is a cancer of the white blood cells. White blood cells normally grow and divide as your body needs them. In leukemia, the bone marrow produces abnormal white blood cells and might not undergo apoptosis–or programmed cell death.
Lymphoma is the most common type of blood cancer.
According to the LLS, we expected 82,310 new US cases of lymphoma in 2019. Compare that to leukemia’s 61,780 for the year.
Lymphoma affects lymphocytes, which are a type of white blood cell. Lymphomas usually happen when lymphocytes mutate and behave abnormally or live longer than they’re supposed to.
These abnormal (cancerous) cells can travel through the blood and the lymphatic system just like normal lymphocytes, meaning they can spread to the lymph nodes, spleen, bone marrow, and other organs.
Main Types of Leukemia
There are four main types of leukemia:
- Acute lymphocytic leukemia (ALL). This is the most common type of leukemia in young children. ALL can also occur in adults.
- Acute myeloid leukemia (AML). AML is a common type of leukemia. It occurs in children and adults. AML is the most common type of acute leukemia in adults.
- Chronic lymphocytic leukemia (CLL). With CLL, the most common chronic adult leukemia, you may feel well for years without needing treatment. (May also present as SLL–a lymphoma)
- Chronic myeloid leukemia (CML). This type of leukemia mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukemia cells grow more quickly.
- Other types. Other, rarer types of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative disorders.
Main Types of Lymphoma
- Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL): CLL/SLL are the same disease with slightly different manifestations. Where the cancerous cells gather determines whether it is called CLL or SLL.
- Hodgkin Lymphoma (HL): There are five types of HL, an uncommon form of lymphoma that involves the Reed-Sternberg cells.
- Non-Hodgkin Lymphoma (NHL): Any lymphoma that does not involve Reed-Sternberg cells is classified as non-Hodgkin lymphoma.
Common First Symptoms of Leukemia vs. Lymphoma
Leukemia usually presents with a change in blood counts, such as severe anemia. This may first show itself as:
- fatigue
- shortness of breath or
- dizziness.
Patients may simply have routine blood work with abnormal results and no other symptoms in some cases.
Typical first symptoms for lymphoma include:
- drenching night sweats
- unexplained weight loss
- fatigue
- enlarged lymph nodes
- abdominal bloating
- back pain
- cough or shortness of breath
- severe itching
In many cases, there are no symptoms, and it may get picked up by a scan done for another reason.
Diagnosis of Leukemia vs. Lymphoma
In testing for leukemia, you’ll most likely undergo a combination of scans and tests. More often than not, you’ll need blood work and a bone marrow biopsy to confirm diagnosis.
For lymphoma, depending on if/where a tumor presents itself, you might need an x-ray or CT scan, blood work, and a needle biopsy or lymph node biopsy to confirm.
Treatment of Leukemia vs. Lymphoma
When talking about the different treatment options for leukemia and lymphoma, it’s important to remember that there are so many different sub-types of each disease and so many other factors that affect an individual’s treatment plan.
“There are 60+ types of lymphoma and at least 10 types of leukemia. Even within lymphoma and leukemia, and even within one disease type it can vary a lot depending on the disease, the patient’s symptoms, age, frailty; whether this is the first treatment or treatment for a relapse; and based on other disease-specific risk factors,” Dr. Fenske says.
For example, we know that for most first-time HL patients, the standard first-line treatment is ABVD chemotherapy, but that doesn’t mean every new HL patient is going to get that treatment. People are individual, and so are treatment plans.
Targeted therapy is a more recent option than traditional chemotherapy and may be paired with other treatments, including chemo. Unlike standard chemotherapy, which affects all cells in the body, targeted therapy directly attacks a specific type of cancer cells, helping to reduce damage to healthy cells and reduce side effects.
Many patients with leukemia or lymphoma may also need blood transfusions if their numbers get too low, and in some cases a stem cell transplant is part of the treatment plan.
Be sure to ask your doctor for all of your options before you make a decision. If you aren’t getting the answers you want, feel free to get a second opinion.
Leukemia Stories
Acute Lymphoblastic Leukemia (ALL)
Evan L., Acute Lymphoblastic Leukemia (ALL)
1st symptoms: Extreme fatigue, easily bruised
Treatment: Chemo infusions, chemo pills, spinal taps, cranial radiation
Casey H., Acute Lymphoblastic Leukemia (ALL)
1st symptoms: Lump on throat, extreme fatigue, shortness of breath, bruising easily
Treatment: Chemo, immunotherapy, radiation, stem cell transplant
Veronica B., Acute Lymphoblastic Leukemia (ALL)
1st symptoms: Mild shortness of breath and palpitations
Treatment: Chemo, targeted therapy, double cord transplant
Christine M., Acute Lymphoblastic Leukemia (ALL)
1st symptoms: Enlarged lymph nodes, pain in abdomen, nausea
Treatment: Chemotherapy, bone marrow transplant
Ciara T., Acute Lymphoblastic Leukemia (ALL)
Cancer details: Treatment without blood tranfusions
1st symptoms: Fatigue, shortness of breath, night sweats, petechiae
Treatment: Chemotherapy
Pediatric Acute Lymphoblastic Leukemia (Ped ALL)
No post found
Acute Myeloid Leukemia (AML)
Sasha T., Acute Myeloid Leukemia (AML)
1st symptoms: Easily bruised and swollen, painful hip
Treatment: 4 chemo infusions, bone marrow transplant
Luisa L., Acute Myeloid Leukemia (AML)
Cancer details: Most common type of acute leukemia in adults
1st symptoms: Painful hives on legs & migraines
Treatment: 3 cycles of chemo, total body radiation & stem cell transplant
Hayley A., Acute Myeloid Leukemia (AML), M5
Cancer details: Most common type of acute leukemia in adults
1st symptoms: Severe fatigue and excessive bleeding after oral surgery
Treatment: Chemotherapy, bone marrow transplant
Nicole T., Acute Myeloid Leukemia (AML)
1st symptoms: Severe itchiness, night sweats, fatigue
Treatment: Chemotherapy, bone marrow transplant
Mary Clare B., Acute Myeloid Leukemia (AML)
Cancer details: Relapsed but in remission after 2nd transplant
1st symptoms: Extreme fatigue, upset stomach, bad & persistent headaches
Treatment: Chemotherapy, radiation, 2 bone marrow transplants
Chronic Lymphocytic Leukemia (CLL)
Susan K.
Symptoms: Swollen lymph nodes on the neck, high white blood count
Treatment: Venetoclax & obinutuzumab
Chronic Myeloid Leukemia (CML)
Michele T., Chronic Myeloid Leukemia (CML)
1st Symptoms: Trouble breathing, rash, bruising
Treatment: Sprycel and Bosulif
Treatment: Tyrosine kinase inhibitors (TKIs) including Sprycel
Lymphoma Stories
Classical Hodgkin Lymphoma
Madi J., Hodgkin's, Stage 1B
Cancer details: Most common and most treatable form of Hodgkin lymphoma
1st Symptoms: Shortness of breath
Treatment: 3 rounds (6 infusions) of ABVD chemo
Danielle D., Hodgkin's, Stage 2
Cancer details: Diagnosed at age 25
1st Symptoms: Swollen lump on right side of neck/chest area, continued to grow
Treatment: ABVD chemotherapy (3 cycles = 6 infusions)
Lani S., Hodgkin's, Stage 2
Cancer details: Tumor pressing on heart
1st Symptoms: Appendicitis led to CT scan that found tumor
Treatment: ABVD chemotherapy, 7 cycles
Jason F., Hodgkin's, Stage 2A
Cancer details: Diagnosed at 39
1st Symptoms: Itchy legs, bloated face and “upper trunk,” slow-healing wounds, asthma worsened
Treatment: 6 cycles (12 infusion) ABVD chemo, 18 radiation therapy sessions
Logan A., Hodgkin's, Stage 2A
Cancer details: Diagnosed at age 15
1st Symptoms: Lump in neck & fatigue
Treatment: 4 cycles of ABVE-PC chemo
Nodular Lymphocyte Predominant Hodgkin Lymphoma
No post found
Anaplastic Large Cell Lymphoma (ALCL)
Brianna B., Anaplastic Large Cell Lymphoma (ALCL)
1st Symptoms: Infections, inflammation, high fever, swelling, abdominal pain
Treatment: Chemo, radiation
...
Chronic Lymphocytic Leukemia (CLL)/ Small Lymphocytic Lymphoma (SLL)
Diffuse Large B-Cell Lymphoma (DLBCL)
Tony W., Relapsed T-Cell/Histiocyte-Rich Large B-Cell Lymphoma (T/HRBCL)
Symptoms: A lot of effort needed cycling, body wasn’t responding the same; leg swelling
Treatments: R-CHOP chemotherapy, CAR T-cell therapy
Stephanie Chuang
Stephanie Chuang, founder of The Patient Story, celebrates five years of being cancer-free. She shares a very personal video diary with the top lessons she learned since the Non-Hodgkin lymphoma diagnosis.
Shahzad B., Refractory Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4
Symptoms: Extreme fatigue
Treatment: R&B, R-ICE, R-EPOCH, CAR T-cell therapy (cell-based gene therapy)
Symptoms: Chest pain, back pain, bump on neck, night sweats Treatment: Chemotherapy, CAR T-Cell therapy
Robyn S., Relapsed Diffuse Large B-Cell Lymphoma (DLBCL), Stage 2E
Symptoms: Enlarged lymph nodes
Treatments: Chemotherapy: R-CHOP, R-ICE, intrathecal, BEAM; autologous stem cell transplant, head and neck radiation, CAR T-cell therapy
Richard P., Relapsed/Refractory Follicular Lymphoma & DLBCL
Relapse Symptoms Swelling in leg, leg edema Treatment: R-CHOP chemotherapy, clinical trial (venetoclax-selinexor)
DLBCL and Burkitt Lymphoma
No post found
Marginal Zone Lymphoma (MZL)
The Importance of Positive Role Models
The example that Nick's father set for him as he was growing up taught him how to prioritize and advocate for his health.
Nick M., Nodal Marginal Zone Lymphoma
1st Symptoms: Daily hives, GI issues, weight loss, heart issues, night sweats
Treatment: Rituxan (rituximab) and high-dose steroids
Kimberly O., Marginal Zone Lymphoma
1st Symptoms: None at first, routine blood work showed suspicious results, bad nosebleed
Treatment: Chemotherapy (bendamustine & rituximab)
Rachel P., Marginal Zone Lymphoma, Gastric MALT
1st Symptoms: Fatigue, bloating, stomach pain
Treatment: Chemotherapy, targeted therapy, surgery
Primary Mediastinal B-Cell Lymphoma (PMBCL)
Arielle R., Primary Mediastinal (PMBCL)
1st Symptoms: Swollen neck lymph nodes, fever, appetite loss, weight loss, fatigue, night sweats, coughing, itchy skin, trouble breathing
Treatment: R-EPOCH (dose-adjusted) chemotherapy, 6 cycles
Keyla S., Primary Mediastinal (PMBCL), Stage 1
1st Symptoms: Bad cough, slight trouble breathing
Treatment: R-EPOCH (dose-adjusted) chemotherapy, 6 cycles
Donna S., Primary Mediastinal (PMBCL), Stage 1-2
1st Symptoms: Visible lump in center of throat, itchy legs, trouble swallowing
Treatment: R-EPOCH (dose-adjusted) chemotherapy, 6 cycles
Patrick M., Primary Mediastinal (PMBCL), Stage 2
1st Symptoms: Bump pushing up into sternum
Treatment: 6 cycles of DA-EPOCH-R (dose-adjusted) chemotherapy at 100+ hours each
Crystal Z., Primary Mediastinal (PMBCL), Stage 2
1st Symptoms: Chest pain
Treatment: 6 cycles of R-CHOP chemotherapy
Waldenstrom Macroglobulinemia
...
Pete D., Waldenstrom Macroglobulinemia
Symptom: Irregular blood test results during a regular workup for Crohn’s
Treatments: Chemotherapy, surgery, radiation, monthly IVIG
...
Sheree N., Waldenstrom Macroglobulinemia
Symptom: Feeling anemic
Treatment: Chemotherapy (bendamustine & rituximab)
...