Leukemia triggers an excessive and uncontrolled proliferation of cells referred to as leukocytes. In the context of acute leukemia, these leukocytes are immature, multiply rapidly, and ultimately turn into dysfunctional entities known as blasts upon exiting the bone marrow. Conversely, chronic leukemia is marked by a more gradual development of leukocytes, which may take a prolonged period to manifest symptoms.
Moreover, chronic leukemia typically involves leukocytes that are more mature and operational, with a low prevalence of blasts.
The term “leukemia” encompasses any cancer type that affects certain cells within an individual’s bone marrow, blood, or lymphatic system. Notably, in the United States, the incidence of leukemia has been on a consistent rise since 2006.
The present article explores the various characteristics of acute and chronic leukemia, examining their respective symptoms, origins, preventative measures, diagnostic processes, and treatment approaches. It further includes insights on the experience of living with leukemia.
Acute versus chronic leukemia distinctions
Leukemia manifests when bone marrow cells proliferate in a disorderly, detrimental fashion. This unregulated cell growth can result in either acute or chronic leukemia based on the development patterns of the disease.
Contrary to common perception, the classification of acute and chronic in leukemia does not correspond to the length of time the disease persists.
In cases of acute leukemia, individuals generate a large number of aberrant cells, referred to as blasts, within the bone marrow. These immature cells multiply briskly, displacing the healthy cells and precipitating an accelerated appearance of symptoms associated with leukemia.
On the contrary, chronic leukemia predominantly involves cells that retain a level of maturity and functionality, leading to a more gradual disease progression. Consequently, individuals might live with leukemia for an extended period, often many years, without any noticeable symptoms emerging.
Other types and subtypes
In addition to categorizing leukemia as acute or chronic, physicians differentiate between myelogenous and lymphocytic leukemia based on the primary affected cell type.
The terminology clarifies if the prevailing cell at issue is of the myeloid or lymphoid lineage.
The primary subtypes encompassing these forms of leukemia include:
- acute lymphoblastic leukemia (ALL)
- acute myelogenous leukemia (AML)
- chronic lymphocytic leukemia (CLL)
- chronic myelogenous leukemia (CML)
Symptoms
Chronic vs. Acute Leukemia Symptoms
While chronic and acute leukemia can produce overlapping symptoms, chronic leukemia symptoms often emerge later and more subtly. It’s possible for a person to exhibit no symptoms for several years post-diagnosis.
Acute Leukemia
Acute leukemia symptoms tend to manifest more quickly and can escalate rapidly. The severity of acute leukemia symptoms can also be greater, with issues such as:
- Persistent tiredness
- Unintentional weight loss
- Recurrent fevers
- Breathlessness
- A pale complexion
- Small red skin spots
- Regular infections that don’t resolve with usual treatments
- Easy bruising or bleeding
- Delayed wound healing
- Discomfort in bones and joints
Chronic Leukemia
Symptoms of chronic leukemia are generally milder and appear at a slower pace compared to acute leukemia.
In some cases, individuals may not exhibit any symptoms initially. Symptoms that might emerge as the cancer advances include:
- Swellings in the neck, underarms, or groin
- Pain or discomfort
- A sensation of abdominal fullness
- Fevers, colds, and persistent night sweats
- General weakness and a feeling of lethargy
Causes
Leukemia arises from disruptions in the normal cell life cycle, leading to abnormal cell proliferation.
The American Cancer Society clarifies the difference between chronic and acute leukemia based on the cell development stage:
- Chronic leukemia stems from an issue occurring after cells have matured, which hinders their ability to fend off infections.
- Acute leukemia involves early-stage cells that are impeded from maturing adequately, resulting in their excessive accumulation.
While the combination of genetic and environmental factors is identified as a contributing cause for cancer, the precise triggers of leukemia are not definitively known.
Researchers have linked leukemia, particularly chronic myeloid leukemia (CML), to certain DNA changes such as the Philadelphia chromosome mutation; notably, this mutation is not hereditary.
Genes have a role in governing the elimination of harmful chemicals from the body. A defective gene can increase the risk of cell damage because the body may struggle to process and dispose of toxic substances effectively if exposure occurs.
Diagnosis
Diagnosing leukemia can be a complex process for physicians. To ascertain the presence of leukemia, several tests might be conducted, which typically include:
- A full blood count (FBC), which examines the different types of cells in the blood.
- A comprehensive metabolic panel (CMP), used to assess various functions and chemical levels in the body including liver and kidney health.
- A liver function test (LFT), to evaluate the liver’s condition and functionality.
The diagnosis process differs between acute and chronic leukemia. Often, acute leukemia diagnosis necessitates a bone marrow biopsy to determine the quantity of blast cells present. In contrast, this procedure may not always be imperative for chronic leukemia diagnosis.
Discover more about the bone marrow biopsy process here.
Treatment
The approach to treating leukemia varies significantly depending on whether an individual is diagnosed with acute or chronic leukemia, as well as the specific subtype involved.
Chronic Leukemia
For those with chronic leukemia, treatment may not be immediately necessary until symptoms manifest, which could take a prolonged duration. However, routine check-ups with a physician are crucial to keep track of the disease’s progression.
Given that chronic leukemia commonly occurs in older individuals, medical professionals frequently opt for targeted therapies. Such treatments are designed to eliminate cancer cells while sparing healthy ones, thus minimizing potential adverse effects.
Chemotherapy Versus Targeted Therapy
Chemotherapy’s objective is to eradicate cancer cells; nonetheless, it can also affect healthy cells. Post-chemotherapy, the goal is to allow for the recovery of these healthy cells.
While effective, chemotherapy can prompt unwanted effects across the body, especially for seniors or those with existing health issues who may struggle to cope with such treatment.
In contrast, targeted therapies specifically target cancer cells, greatly reducing the likelihood of broader complications.
Explore various treatment processes based on the stage of CML here.
Acute Leukemia
The treatment of acute leukemia hinges on the severity of the condition and its unique genetic factors.
Medical practitioners may initiate treatment with a targeted therapy medication or chemotherapy.
Subsequently, the focus shifts to ensuring the complete eradication of harmful cells, achieved through additional chemotherapy or a stem cell transplant.
Outlook
The prognosis for leukemia patients is highly variable and hinges on multiple variables, including their age, existing medical conditions, and the specific leukemia subtype they have.
Chronic Leukemia
People diagnosed with chronic leukemia may live extensive, fulfilling lives, even though the condition might not be curable. Some individuals with chronic leukemia can remain asymptomatic for extended periods and only seek treatment upon symptom development.
Acute Leukemia
Acute leukemia represents a rapidly advancing form of the disease. However, treatment advancements have significantly improved patient outcomes. A 2021 study revealed that treatment advancements over the past four decades have notably improved survival rates for acute lymphoblastic leukemia (ALL).
For instance, prior to 1990, the 5-year survival rate for ALL was reported at 51%. Post-2010, this rate escalated to 72%, with survival rates for children under 15 soaring from 73% to 93% within that same period.
The term ‘survival rate’ signifies the percentage of patients who survive a specified amount of time after a diagnosis. For instance, a 5-year survival rate of 50% indicates that half of the patients survive at least five years post-diagnosis.
These statistics are general projections based on historical data, and individual outcomes may vary. Patients should consult their healthcare providers for personalized assessments of their diagnoses.
Summary
Acute leukemia emerges when white blood cells, still immature and dividing quickly, transform into malfunctioning blasts upon exiting the bone marrow.
On the flip side, chronic leukemia progresses more steadily, often taking extended periods to show any symptoms. This type usually includes cells that are more developed and functional, with a low presence of blast cells.
Those diagnosed with chronic leukemia may often enjoy a standard life quality, with generally favorable long-term prospects.
In contrast, acute leukemia is characterized by its rapid progression. Nevertheless, current strides in treatment research are expanding the choices available, thereby enhancing patient outlooks.
