Difference Between Acute and Chronic Leukemia (With Table)

Leukemia is blood cancer in common terms. It is a cancer of blood-forming tissues (including bone marrow) which inhibits the ability of the body to fight infection. In simple terms, it affects the immune system of the body. Leukemia is of two major types – Acute Leukemia and Chronic Leukemia.

Acute vs Chronic Leukemia

The main difference between acute and chronic leukemia is that acute leukemia is a type of blood cancer that generally occurs in children and progresses rapidly and spreads to organs like the brain, liver, and spleen while chronic leukemia is a type of blood cancer that generally occurs in adults but spreads slowly.

Acute leukemia affects the stem cells and forms structures called blasts. It affects the lymphocytes and inhibits the functioning of the immune system. Acute leukemia is of two types. The symptoms of acute leukemia are often confused with other diseases and delay remission.

While chronic leukemia hinders the development of blood stem cells. Due to slow progression, the abnormal cells accumulate and stop functioning. Chronic leukemia is of two types. The symptoms of chronic leukemia may not appear for a long period which can further delay the treatment and cause severity.

Comparison Table Between Acute and Chronic Leukemia

Parameters of ComparisonAcute LeukemiaChronic Leukemia
CauseProlonged contact with radiation and chemicals, or from infection or genetic disorders Contact with certain chemicals, herbicides, and insecticides
SymptomsFever, fatigue, loss of appetite, stomach pain or swelling, joint pain, trouble breathing, headache, blurred vision, or unusual bleeding, pale skin Enlargement of lymph nodes, abdominal pain in the left region, fever, weight loss, dizziness, difficulty in breathing and abnormal blood loss
Age groupIn children Older adults
DiagnosisExamination of medical history and tests like complete blood count (CBC) test, bone marrow tests, spinal tap, imaging tests like X-rays, CT scan, or ultrasound Lymphocytosis, complete blood count (CBC) test, smudge cell test, imaging tests like CT and PET (Positron Emission Tomography), clinical staging and Array-based karyotyping
TreatmentChemotherapy, targeted therapy, radiation therapy, immunotherapy, stem cell transplant, CAR T-cell therapy, and the drug tisagenlecleucel (kymriah) Six types of treatment are available – watchful waiting, targeted therapy, chemotherapy, radiation therapy, immunotherapy, and chemotherapy with bone marrow (Peripheral stem cell transplant)

What is Acute Leukemia?

Acute Leukemia is a type of blood cancer. It begins in the white blood cells (WBCs) which are present in the bone marrow. The word ‘acute’ signifies the tendency to get worse rapidly. It is mostly found in children.

Acute Leukemia does not form a tumor but spreads to vital organs like the brain, spleen, liver, or lymph nodes. It forms immature lymphocytes and affects the immune system. Some possible causes of acute leukemia are contacted with radiating objects or chemicals (like benzene, cleaning products, or paint) or infection from a human T-cell (lymphoma). Sometimes, genetic disorders like Down Syndrome could also lead to acute leukemia.

Symptoms of Acute Lymphoblastic leukemia are vast, varied, and vague. Some common symptoms are fever, stomach pain, loss of appetite and rapid weight loss, fatigue, shortness of breath, and night sweats while some develop red spots under the skin which is called petechiae. The lymph nodes near the neck and arm may enlarge and even the belly can become if cancer has spread to the liver or spleen.

Acute leukemia can be treated in two parts if diagnosed early – induction therapy (to kill leukemia cells and bring them under control) and post-remission therapy (cycle of treatment for 2-3 years).

What is Chronic Leukemia?

Chronic leukemia is a type of blood cancer. The term ‘chronic’ signifies that the progression is slower than other types of leukemia. It affects the lymphocytes which are an essential component of the immune system.

Though the exact cause of the change in DNA of the lymphocytes is not known, exposure to certain chemicals, herbicides, insecticides, or a family history of blood and bone marrow cancers or development of Monoclonal B-cell Lymphocytes (MBL) which causes excessive lymphocytes.

Chronic leukemia does not develop major symptoms for a long time. Some common symptoms are fever, fatigue, night sweats, weight loss, enlargement of lymph nodes, blood loss from a small bruise or wound, pain in the abdomen, or occurrence of frequent infections. Chronic leukemia can cause risk to several other kinds of cancer like skin or lung cancer. It has the potential to turn into an aggressive form which is called Richter’s syndrome.

It can be diagnosed through blood tests, bone marrow biopsy, and Imaging tests. Six major types of treatment can be provided to a patient with Chronic leukemia while there are several types of treatment tested in clinical trials. Some treatments can cause serious side effects too.

Main Differences Between Acute and Chronic Leukemia

  1. Acute Leukemia progresses rapidly while chronic leukemia grows slowly with or without treatment.
  2. Acute leukemia is of two types – Acute lymphocytic leukemia (ALL) and Acute Myelogenous leukemia (AML) while Chronic Leukemia is of two types – Chronic Lymphocytic leukemia (CLL) and Chronic Myelogenous Leukemia (CML).
  3. Acute leukemia develops in children while chronic leukemia develops in adult men at a higher rate.
  4. Acute leukemia affects the stem cells and is called blasts while chronic leukemia affects the partially matured abnormal lymphocytic cells
  5. Acute leukemia can include risk factors like smoking cigarettes, genetic abnormalities, exposure to radiation, or ongoing radiation therapy while chronic leukemia includes risk factors like being a European descendant, age over 60, radiation exposure, or chemicals (like benzene and Agent Orange).

Conclusion

Leukemia affects the blood cells and the bone marrow. It actively inhibits the immune responses which in turn brings about several infections and increases the severity of the condition. Many patients with leukemia do not have any symptoms but minor symptoms like fatigue or loss of appetite should always be monitored.

Treatment of every leukemia condition is different. Some slow-growing leukemias require monitoring while aggressive leukemia may require an immediate stem-cell transplant. It is still a field where new drugs and treatment procedures are under clinical trials every day.

References

  1. https://journals.lww.com/cancernursingonline/fulltext/1997/04000/explaining_different_profiles_in_quality_of_life.4.aspx
  2. https://ashpublications.org/blood/article-abstract/96/6/2240/181051
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