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.

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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.

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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)

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)

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

Stephanie O., Hodgkin's, Stage 2B



Cancer details: Stage 2 with bulky disease
1st Symptoms: Shortness of breath, dry cough
Treatment: Stanford V chemotherapy (12 weeks, 1 infusion each week), radiation (20 days)

Fabiola L., Hodgkin's, Stage 2BX



Cancer details: Stage 2 with bulky disease, relapsed after 1st chemo. Remission after 2nd chemo & bone marrow transplant
1st Symptoms: Shortness of breath, dry cough, fatigue
Treatment: ABVD chemo (6 cycles), IGEV chemo, bone marrow transplant, BEAM chemo, brentuximab

Moe C., Hodgkin's, 2B, Relapse



Cancer details: Diagnosed at 19, relapsed before remission
1st Symptoms: Fatigue, weight loss, night sweats
Treatment: ABVD chemo, DHAP chemo, MINE-R chemo, splenectomy, autologous bone marrow transplant

Wade W., Hodgkin's, Stage 2A



Cancer details: Diagnosed at 18 years old
1st Symptoms: Enlarged lymph nodes (around neck), diagnosed at 18 years old
Treatment: ABVD chemotherapy (2 cycles), AVD chemotherapy (4 cycles)

Lauren C., Hodgkin's, Stage 2A



Cancer details: Diagnosed at 23 years old with nodular sclerosis, relapsed after 6 months of 1st-line treatment
1st Symptoms: Itchy body, enlarged lymph node over collar bone
Treatment: ABVD chemotherapy and ICE, radiation, and stem cell transplant for relapse

Helicon K., Hodgkin's, Stage 2A



Cancer details: Found lymphoma cells in adenoid tissue
1st Symptoms: Difficulty breathing with blockage in nose, surgery to remove tissue resulted in discovery of Hodgkin lymphoma cells
Treatment: ABVD chemotherapy (4 cycles), radiation (20 sessions)

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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)

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



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

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

Luis V., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Symptoms: Persistent cough, fatigue, unexplained weight loss



Treatment: Chemotherapy (R-CHOP and methotrexate)

Richard P., Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Relapse Symptoms: Swelling in leg, leg edema Treatments: R-CHOP chemotherapy, clinical trial (venetoclax-selinexor)

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DLBCL and Burkitt Lymphoma

Marginal Zone Lymphoma (MZL)

Primary Mediastinal B-Cell Lymphoma (PMBCL)

Waldenstrom Macroglobulinemia

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