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)

Evan L., Acute Lymphoblastic Leukemia (ALL)



Symptoms: Extreme fatigue, easily bruised
Treatments: Chemotherapy, spinal taps, cranial radiation

Casey H., Acute Lymphoblastic Leukemia (ALL)



Symptoms: Lump on the throat, extreme fatigue, shortness of breath, bruising easily

Treatments: Chemotherapy, immunotherapy, radiation, stem cell transplant

Veronica B., Acute Lymphoblastic Leukemia (ALL)



Symptoms: Mild shortness of breath, palpitations
Treatments: Chemotherapy, targeted therapy, double cord transplant

Christine M., Acute Lymphoblastic Leukemia (ALL)



Symptoms: Enlarged lymph nodes, pain in abdomen, nausea

Treatments: Chemotherapy, bone marrow transplant

Ciara T., Acute Lymphoblastic Leukemia (ALL)



Symptoms: Fatigue, shortness of breath, night sweats, petechiae

Treatments: Chemotherapy, monoclonal antibody

Pediatric Acute Lymphoblastic Leukemia (Ped ALL)

Acute Myeloid Leukemia (AML)

Sasha T., Acute Myeloid Leukemia (AML)



Symptoms: Easily bruised and swollen, painful hip
Treatments: Chemotherapy, bone marrow transplant

Luisa L., Acute Myeloid Leukemia (AML) with FLT3 Mutation



Symptoms: Painful hives on legs, migraines
Treatments: Chemotherapy, total body radiation, stem cell transplant

Hayley A., Acute Monocytic Leukemia (AML-M5)



Symptoms: Severe fatigue, excessive bleeding after oral surgery
Treatments: Chemotherapy, bone marrow transplant

Nicole T., Acute Myeloid Leukemia (AML)



Symptoms: Severe itchiness, night sweats, fatigue
Treatments: Chemotherapy, bone marrow transplant

Mary Clare B., Acute Myeloid Leukemia (AML)



Symptoms: Extreme fatigue, upset stomach, bad & persistent headaches
Treatments: Chemotherapy, radiation, bone marrow transplants

Chronic Lymphocytic Leukemia (CLL)

Bill M.



Symptoms: Tightness, lumps in left side of neck, severe pain in left shoulder, enlarged spleen
Treatment: EPOCH, clinical trial (DuoHexabody-CD37)

Stephen B.



Symptoms: Difficulty swallowing, fatigue
Treatment: Rituxan, bendamustine, BTK inhibitor (ibrutinib)

Sean R.



Symptoms: No apparent symptoms; went to ER for unrelated shoulder pain
Treatment: Clinical trial (ibrutinib & venetoclax)

Lacey B.




Symptoms: Extreme fatigue, elevated WBCs
Treatment: Chemotherapy (FCR), venetoclax + rituximab

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

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

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)

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

Lynn B.



1st Symptoms: Prolonged fever and night sweats



Treatment: Rituxan infusion, ibrutinib daily

Diffuse Large B-Cell Lymphoma (DLBCL)

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



Symptoms: Blood in urine
Treatment: Surgery, chemotherapy (R-CHOP), radiation

Leanne T., Follicular Lymphoma Transformed to DLBCL, Stage 3B



Symptoms: Fatigue, persistent cough
Treatment: R-CHOP chemotherapy, 6 rounds

Kris W., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Symptoms: Pain in the side of the abdomen
Treatment: R-CHOP chemotherapy

Jonathan S., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Symptoms: Severe shoulder pain
Treatment: 6 rounds of R-CHOP chemotherapy, 10 rounds of methotrexate, 12 rounds of focal radiation, autologous stem cell transplant

Harriet C., Diffuse Large B-Cell Non-Hodgkin Lymphoma (DLBCL) Symptoms: Weight loss, difficulty walking, stomach pain, feeling unwell Treatment: Chemotherapy, EPOCH, methotrexate

Erin R., DLBCL & Burkitt Lymphoma, Stage 4



Symptoms: Lower abdominal pain, blood in stool, loss of appetite
Treatment: Chemotherapy (Part A: R-CHOP, HCVAD, Part B: Methotrexate, Rituxan, Cytarabine)

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DLBCL and Burkitt Lymphoma

Marginal Zone Lymphoma (MZL)

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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

Kay, Waldenstrom Macroglobulinemia Symptoms: Nosebleeds, fatigue, fainting, bruises, hair loss Treatments: Chemotherapy (R-CHOP), Rituximab
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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)
...

Cindy S., Waldenstrom Macroglobulinemia



Symptom: Hyperproteinemia

Treatment: Chemotherapy
...

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