Answer: -

Leukemia is a type of cancer that affects the blood and bone marrow, where blood cells are
produced. It is characterized by the uncontrolled production of abnormal white blood cells,
which interfere with the normal functioning of the blood. Leukemia is classified based on two
factors: the speed of progression (acute or chronic) and the type of affected blood cell
(lymphoid or myeloid). This results in four main types of leukemia:

1. Acute Lymphocytic Leukemia (ALL)

2. Acute Myelogenous Leukemia (AML)
3. Chronic Lymphocytic Leukemia (CLL)
4. Chronic Myelogenous Leukemia (CML)

1. Acute Lymphocytic Leukemia (ALL)

● Classification: Acute, Lymphoid (affects lymphocytes)

o ALL primarily affects lymphocytes, a type of white blood cell involved in immune
responses. It is the most common type of leukemia in children but can also affect adults.
o In ALL, there is an overproduction of immature white blood cells called lymphoblasts.
These cells do not function properly and accumulate in the bone marrow and
bloodstream, leading to the disruption of normal blood cell production.
● Symptoms:
o Fatigue, fever, frequent infections, easy bruising or bleeding, swollen lymph nodes, pale
skin, bone pain, and weight loss.
● Diagnosis:
o A blood test showing a high number of immature lymphocytes, confirmed by bone
marrow biopsy.

2. Acute Myelogenous Leukemia (AML)

● Classification: Acute, Myeloid (affects myeloid cells)

● Description:
o AML affects myeloid cells, which are responsible for producing red blood cells, white
blood cells (excluding lymphocytes), and platelets.
oLike ALL, AML is characterized by the rapid accumulation of abnormal, immature cells
called myeloblasts. These cells crowd out normal blood cells in the bone marrow,
leading to symptoms such as anemia and susceptibility to infections.
● Symptoms:
o Fatigue, fever, easy bruising or bleeding, pale skin, frequent infections, shortness of
breath, and swelling of the gums.
● Diagnosis:
o A blood test showing elevated myeloblasts, followed by bone marrow biopsy to confirm
the diagnosis and determine the subtypes of AML.
3. Chronic Lymphocytic Leukemia (CLL)

● Classification: Chronic, Lymphoid (affects lymphocytes)

● Description:
o CLL involves the slow accumulation of mature lymphocytes that do not function
properly. Unlike ALL, which is characterized by the rapid growth of immature cells, CLL
progresses slowly and involves the buildup of abnormal, mature lymphocytes.
o It predominantly affects older adults and is more common in men than in women. The
disease often begins in the lymph nodes but can spread to the bone marrow, liver, and
spleen.
● Symptoms:
o Often asymptomatic in the early stages. Symptoms may include swollen lymph nodes,
fatigue, weight loss, fever, frequent infections, and easy bruising or bleeding.
● Diagnosis:
o A blood test showing a high number of mature lymphocytes. Bone marrow biopsy may
be used to assess the extent of the disease.

The progression of CLL is slow, and many patients live for many years without
treatment. However, when treatment is required, it usually involves chemotherapy or
targeted therapies.

4. Chronic Myelogenous Leukemia (CML)

● Classification: Chronic, Myeloid (affects myeloid cells)

● Description:
o CML affects myeloid cells, leading to the overproduction of abnormal white blood cells.
o A distinctive feature of CML is the presence of the Philadelphia chromosome, a genetic
abnormality where a piece of chromosome 9 swaps places with chromosome 22. This
results in the production of a fusion protein that promotes the uncontrolled growth of
myeloid cells.
o CML usually progresses through three phases: chronic, accelerated, and blast crisis,
where the disease becomes more aggressive.
● Symptoms:
o In the early stages, CML may have no symptoms or mild symptoms like fatigue, weight
loss, fever, and splenomegaly (enlarged spleen). In the advanced stages, the disease can
cause more severe symptoms like bone pain, bleeding, and infections.
● Diagnosis:
o Blood tests often reveal an increased number of white blood cells. The presence of the
Philadelphia chromosome is diagnosed using cytogenetic testing.

Basic Differences between the Types of Leukemia

Feature ALL AML CLL CML

Type of
Acute Acute Chronic Chronic
Leukemia
Affected Lymphoid (immature Myeloid Lymphoid (mature Myeloid (mature
Cells lymphocytes) (immature lymphocytes) myeloid cells)
 Feature ALL AML CLL CML
myeloblasts)
Age Group Primarily children, Primarily adults,
Mostly adults Primarily older adults
Affected but adults too often elderly
Slow progression,
Rapid, develops Rapid, develops
Onset Slow progression but becomes
quickly quickly
aggressive
Fatigue, fever, easy
Fatigue, fever, Often asymptomatic
Fatigue, weight
Symptoms bruising, swollen
bleeding, early; swollen lymph
loss, splenomegaly
lymph nodes infections nodes, fatigue
Good for children, Variable; poor for Often long survival Improved with
Prognosis
poorer for adults older adults with slow progressiontargeted therapy
Key High number of High number of Presence of
High number of
Diagnostic lymphoblasts in
myeloblasts in Philadelphia
mature lymphocytes
Features blood blood chromosome
Chemotherapy, Targeted therapy
Chemotherapy, stem Chemotherapy,
Treatment stem cell (Imatinib),
cell transplant targeted therapy
transplant chemotherapy

The classification of leukemia into acute or chronic and lymphoid or myeloid helps differentiate the
types of leukemia based on their progression and the type of white blood cell involved. Acute leukemias
(ALL and AML) are characterized by rapid onset and a high number of immature blood cells, whereas
chronic leukemias (CLL and CML) progress slowly, with more mature white blood cells involved.