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?

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.

  Source

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.

  Source

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)

Tatijane W.



Symptoms: Bone pain in ribs, trouble breathing, fast heart rate, painful lymph nodes in the neck, lump in between breasts
Treatments: Chemotherapy, double CAR T-cell therapy (clinical trial), bone marrow transplant

William Y., Acute Lymphoblastic Leukemia (ALL)



Symptoms: Extreme fatigue, achey hands
Treatments: Chemotherapy, CAR T-Cell therapy

Safyaa I., B-Cell Acute Lymphoblastic Leukemia (B-ALL)



Symptoms: Shortness of breath, dizziness, extreme fatigue, night sweats, audible heartbeat in the ears and tinnitus
Treatment: Chemotherapy

Anna T., B-Cell Acute Lymphoblastic Leukemia, Philadelphia chromosome-negative (Ph-ALL)



Symptoms: Heavy period for a few hours, fatigue, feverish, sweating, bruises on legs
Treatment: ECOG 10403

• 1
• 2
• 3

Pediatric Acute Lymphoblastic Leukemia (Ped ALL)

Acute Myeloid Leukemia (AML)

Renée F.



Symptoms: Bruising
Treatment: Chemotherapy, radiation, allogeneic bone marrow transplant

Michele G., Acute Myeloid Leukemia (AML)



1st symptoms: Bruising, tiredness, shortness of breath, itching



Treatment: IV chemo, 2 stem cell transplants, targeted chemo pill

McKenzie R. Acute Promyelocytic Leukemia (APL)




1st symptoms: Repeat sinus infections, abnormally heavy menstrual cycle
Treatment: Chemotherapy (ATRA oral pill & Arsenic trioxide infusions)

Leslie T., Acute Promyelocytic Leukemia (APL)



Cancer details:A sub-type of AML
1st symptoms:Fatigue, joint paint, migraines, bruising easily, trouble breathing
Treatment:Chemotherapy (Atra & arsenic)

Load More

Chronic Lymphocytic Leukemia (CLL)

Susan K., Chronic Lymphocytic Leukemia



Symptoms: Swollen lymph nodes on the neck, high white blood count
Treatments: Venetoclax & obinutuzumab

Hannah D., Chronic Lymphocytic Leukemia



Symptoms: Fatigue, high WBC



Treatments: Imbruvica, venetoclax

Andrew Schorr, Chronic Lymphocytic Leukemia & MyelofibrosisDiagnosis: Myelofibrosis, Chronic Lymphocytic Leukemia (CLL)Treatment: Clinical trial, Gazyva, Jakafi, Increbic, Reblozyl and steroids

Jeff F., Chronic Lymphocytic Leukemia



Symptoms: Fatigue, night sweats



Treatment: Clinical trial (ofatumumab)

• 1
• 2
• 3
• 4

Chronic Myeloid Leukemia (CML)

Michele T., Chronic Myeloid Leukemia (CML)



Symptoms: Trouble breathing, rash, bruising



Treatments: Sprycel and Bosulif

Mark K., Chronic Myeloid Leukemia (CML)



Initial Symptoms: Weight loss, low energy, night sweats, enlarged spleen, elevated WBC count, frequent need to urinate

Treatment: Tyrosine kinase inhibitors (TKIs)

Lymphoma Stories

Classical Hodgkin Lymphoma

Patrick C., Hodgkin’s Lymphoma, Stage 2B



Initial Symptom: Dry cough, difficulty breathing
Treatment: Chemotherapy (ABVD)

Nicole D., Hodgkin’s



Initial Symptom: Fatigue, random rash
Treatment: Chemotherapy (ABVD)

Samantha S., Relapsed Hodgkin’s



Symptoms: Fatigue, cough, enlarged lymph node
Treatment: ABVD chemotherapy (later changed to AVD), Brentuximab, Cyclophosphamide, BEAM chemotherapy, autologous bone marrow transplant

Manda M., Relapsed Hodgkin’s, Stage 2B



Symptoms: Loss of menstrual cycles, iron deficiency, itching, night sweats, tiredness, night terrors, trouble breathing, difficulty concentrating, enlarged lymph nodes
Treatment: ABVD chemotherapy, radiation, ICE chemotherapy, bone marrow transplant

Kelsey R., Hodgkin’s, Stage 2A



Symptoms: Bad leg itching with no rash, enlarged lymph nodes
Treatment: ABVD chemotherapy, radiation

Emmanuel S., Relapsed Hodgkin’s



Symptoms: Enlarged lymph nodes
Treatments: Chemotherapy: ABVD, ICE; autologous stem cell transplant; Targeted therapy: Brentuximab

• 1
• 2
• 3
• 4
• 5
• 6

Nodular Lymphocyte Predominant Hodgkin Lymphoma

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)

Michael E., Relapsed Diffuse Large B-Cell Lymphoma (DLBCL)



Symptoms: Back & leg pain, rash, severe itching, decreased appetite, weight loss
Treatments: Chemotherapy, CAR T-cell therapy, clinical trial (no improvement from study drug), immunotherapy (epcoritamab)

Barbara R., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Symptom: Abdominal and gastric pain



Treatments: Chemotherapy R-CHOP, CAR T-cell therapy, study drug CYT-0851

Lena V., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 1



Symptom: Blood in urine
Treatments: Surgery, chemotherapy (R-CHOP), radiation

Cindy M., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Symptoms: Itchy skin on the palms and soles of feet; yellow skin and eyes
Treatment: Chemotherapy (R-CHOP)

Load More

DLBCL and Burkitt Lymphoma

Marginal Zone Lymphoma (MZL)

Primary Mediastinal B-Cell Lymphoma (PMBCL)

Sonia S., Primary Mediastinal (PMBCL), Relapse, CAR T-Cell Therapy



1st Symptoms: Chest pain, superior vena cava syndrome (SVCS); persistent, dry coughs, headaches
Treatment: (1st Line) R-CHOP chemotherapy, 6 cycles (2nd Line) R-ICE Chemotherapy (3rd Line) CAR T-cell therapy

Mags B., Primary Mediastinal (PMBCL), Stage 4



Symptoms: Exhaustion, migraines, persistent coughs, swelling and discoloration in left arm
Treatment: Chemotherapy (R-CHOP, 6 cycles)

Stephanie C., Primary Mediastinal (PMBCL), Stage 3

1st Symptoms: Visible swelling around the jaw and neck area, major fatigue
Treatment: R-EPOCH (dose-adjusted) chemotherapy, 6 cycles

Crystal Z., Primary Mediastinal (PMBCL), Stage 2



Symptom: Chest pain
Treatment: 6 cycles of R-CHOP chemotherapy

Load More

Waldenstrom Macroglobulinemia

Other Cancer General Info Articles

What is Leukemia? What is Lymphoma?

Leukemia is a cancer of the white blood cells. Lymphoma affects lymphocytes–a type of white blood cell. What are the similarities and differences of leukemia and lymphoma? How are they diagnosed? How are they treated?...

What is Myelofibrosis?

Myelofibrosis is an uncommon bone marrow cancer that affects blood cell production. Learn more about this disease...