What Is the Difference Between Leukemia and Lymphoma?

Cancer can affect any part of the body, including blood. Leukemia and lymphoma are hematological cancers, originating in blood and bone marrow. Their main difference is that leukemia affects blood and bone marrow, whereas lymphoma affects lymph nodes.

Although these cancers share similarities, their origins, causes, symptoms, treatments, and survival rates differ.

This article examines the differences and similarities between leukemia and lymphoma.

Figure 1: Differences between leukemia and lymphoma according to their sites of origin

What Are Leukemia and Lymphoma?

Leukemia and lymphoma are two blood cancer types. Both generally affect leukocytes, or white blood cells.

What Is Leukemia?

Leukemia develops when the bone marrow produces many abnormal white blood cells. There are numerous subtypes according to the cell involved; some progress slowly, others rapidly.

Leukemia is generally treated with intensive chemotherapy regimens requiring long recovery periods.

In leukemia, abnormal white cells do not die when they should. They instead multiply rapidly, leaving less room for red cells that carry oxygen around the body.

Figure 2: Blood Cell Types and Origins

There are 4 main leukemia types, classified by how quickly they grow and where they begin.

What Are the Types of Leukemia?

• Acute lymphocytic leukemia
• Chronic lymphocytic leukemia
• Acute myeloid leukemia
• Chronic myeloid leukemia

What Is Lymphoma?

Lymphoma starts in immune system lymph nodes and affects lymphocytes, a white blood cell type. There are two main lymphocyte types: B cells and T cells.

The two main lymphoma types are:

1. A type containing an abnormal B cell called a Reed-Sternberg cell: Hodgkin lymphoma.
2. Arising from either B cells or T cells is non-Hodgkin lymphoma.

These types reflect the cancer cell’s origin and how rapidly it spreads.

Lymphoma type affects symptoms and determines treatment options.

How Common Are Leukemia and Lymphoma?

Lymphoma is somewhat more common than leukemia.

In Türkiye, detailed statistics are available for non-Hodgkin lymphoma among leukemia and lymphoma types. It is the 7th most common cancer in men, diagnosed in approximately 5500 men annually, and the 8th most common in women, diagnosed in approximately 4100 women annually.

United States statistics estimated 60,300 new leukemia and 83,180 new lymphoma diagnoses in 2018.

Both diseases are more common in men than women. Lymphoma is estimated to have a higher survival rate than leukemia.

Leukemia and Lymphoma Symptoms

Leukemia Symptoms:

• Enlarged lymph nodes
• Shortness of breath
• Fatigue
• Fever
• Nosebleeds or bleeding gums
• Weakness and dizziness
• Chronic or nonhealing infections
• Easy bruising
• Loss of appetite
• Abdominal swelling
• Unintentional weight loss
• Rust-colored skin patches
• Bone pain or tenderness
• Especially at night, excessive sweating.

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Lymphoma symptoms vary by type. For example:

Hodgkin Lymphoma Symptoms:

• A lump beneath the skin, generally in the groin, neck, or armpit
• Fever
• Unintentional weight loss
• Fatigue and weakness
• Excessive night sweats
• Loss of appetite
• Cough or shortness of breath
• Severe itching

Non-Hodgkin Lymphoma Symptoms:

• Abdominal swelling
• Feeling full after eating little
• Fever
• Enlarged lymph nodes
• Fatigue and weakness
• Shortness of breath
• Cough
• Chest pressure and pain
• Weight loss
• Sweating and chills

Causes and Origins of Leukemia and Lymphoma

These two different conditions arise from problems involving white blood cells.

Leukemia results when bone marrow produces many white cells that fail to die in their normal cycle. They continuously multiply and crowd out other cells.

In some cases, leukemia begins in lymph nodes, which help the immune system fight infections. Lymphoma similarly usually begins in lymph nodes or other lymphatic tissues.

All lymph nodes are interconnected. Hodgkin lymphoma spreads from one node to another.

Non-Hodgkin lymphoma may spread in a less orderly pattern.

In both types, cancer may spread to bone marrow, lungs, or liver.

What Increases Leukemia and Lymphoma Risk?

Chronic leukemia is common in adults. Children, by contrast, are more likely to receive an acute leukemia diagnosis. Acute leukemia is the most common childhood cancer.

Anyone can develop leukemia. Risk factors include:

• Genetic disorders
• Family history 
• Exposure to certain chemicals
• Previous radiotherapy or chemotherapy 
• Smoking

Lymphoma can occur at any age. Hodgkin lymphoma usually occurs between ages 15-40 or after 50. Non-Hodgkin lymphoma can occur at almost any age but is more common in adults.

Hodgkin Lymphoma Risk Factors Include:

• Family history
• A weakened immune system
• Previous Epstein-Barr virus (EBV) infection 
• HIV infection. Non-Hodgkin lymphoma risk factors include: 
• A weakened immune system
• Chemical exposure
• Chronic Helicobacter pylori infection 
• Previous radiotherapy or chemotherapy 
• Autoimmune disease

Note: Having a cancer-related risk factor does not mean you will necessarily develop that cancer. Likewise, having no risk factors does not guarantee protection. Risk factors increase the likelihood of developing the diseases for which they are identified.

How Are Leukemia and Lymphoma Diagnosed?

Their diagnostic processes differ, but both require a medical history and physical examination.

To diagnose leukemia, doctors check abnormal blood levels with blood tests and perform a bone marrow biopsy.

Bone marrow biopsy generally does not require hospitalization. Local anesthetic is given before sampling. In some cases, chromosome testing, X-rays, or CT may be requested.

If lymphoma is suspected, the affected lymph node is removed for pathological examination. This may require general anesthesia, although local anesthesia can also be used.

How Are Leukemia and Lymphoma Treated?

Leukemia is generally treated with intensive chemotherapy regimens requiring long recovery periods.

Leukemia and lymphoma need different approaches. Their subtype also affects cancer treatment.

Chronic leukemias do not require immediate intervention. Doctors may monitor progression, an approach commonly used in chronic lymphocytic leukemia.

Leukemia Treatments Include:

• Chemotherapy
• Stem cell transplantation
• Targeted therapy 
• Biological therapy
• Radiotherapy

Early Hodgkin lymphoma is easier to treat than non-Hodgkin lymphoma.

Hodgkin and Non-Hodgkin Lymphoma Treatments May Include:

• Radiotherapy 
• Chemotherapy
• Medicines that prevent abnormal cell growth 
• Targeted therapy
• Immunotherapy 
• High-dose chemotherapy and stem cell transplantation
• Surgery, rarely

Conclusion

The 5-year survival rate describes people living at least 5 years after diagnosis. Survival varies by cancer stage and type.

Leukemia and lymphoma are among the cancers with the fastest treatment advances and most effective therapies. According to the American Cancer Society, 5-year survival is 86% for Hodgkin lymphoma and 70% for non-Hodgkin lymphoma. According to the United States National Cancer Institute, 5-year leukemia survival during 2008-2014 was 61%.

There is currently no recommended population-based cancer screening test for leukemia or lymphoma. Some subtypes progress very slowly and are called indolent. Slow-growing types may be easier to recognize. Cancer is generally easier to treat when detected early. Alongside overall health, early treatment improves a person’s outlook.

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