Leukemias and myeloma are both blood cell cancers. Both share common symptoms and signs. Both require chemotherapy, radiotherapy and supportive care. However, there are certain differences between leukemia and myeloma and that will be discussed here in detail, explaining individually the clinical features, causes, symptoms and signs, investigation and diagnosis, and prognosis of each and the treatment required for each case.
Leukemia is a type of blood cell cancer. There are four types of leukemia. They are acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML). Most leukemias are initiated by specific genetic mutations, deletions or translocations.
Acute lymphoblastic leukemia (ALL) manifests as neoplastic proliferation of lymphoblasts (immature lymphocytes). WHO classification divides ALL into B lymphocytic leukemia and T lymphocytic leukemia. Immunologically ALL is classified as T cell ALL, B cell ALL, Null-cell ALL, and common ALL. Their symptoms and signs are due to marrow failure. Low hemoglobin, infections, bleeding, bone pain, joint inflammation, spleen enlargement, lymph node enlargement, thymus enlargement, and cranial nerve palsies are common features of ALL. Zoster, CMV, measles, and candidiasis are common infections seen in ALL patients. Preventing infections with prompt antibiotic therapy and vaccination, chemotherapy to induce remission, consolidate and maintain remission are important steps in managing ALL. Bone marrow transplantation also plays a major role in managing ALL.
Acute myeloid leukemia (AML) is a neoplastic proliferation derived from marrow myeloid elements. It is a very rapidly progressive malignancy. There are five types of AML. They are AML with genetic abnormalities, AML with multi-lineage dysplasia, AML myelodysplastic syndrome, AML of ambiguous lineage, and uncategorized AML. Anemia, infection, bleeding, disseminated intravascular coagulation, bone pain, cord compression, large liver, large spleen, lymph node enlargement, malaise, lethargy, and joint pain are common features of AML. Supportive care like blood transfusion, antibiotics, chemotherapy and bone marrow transplantation are the usual treatment methods.
Chronic myeloid leukemia (CML) is characterized by uncontrolled proliferation of myeloid cells. It accounts for 15% of leukemias. It is a myelo-proliferative disorder, having features common with these diseases. Weight loss, gout, fever, sweats, bleeding, and abdominal pain, anemia, large liver and spleen are common features. Philadelphia chromosome, which is a hybrid chromosome formed after a translocation of chromosome 9 to 22. Imatinib mesylate, hydroxyurea, and allogenic transplantation are commonly used treatment methods.
Chronic lymphocytic leukemia (CLL) is a monoclonal proliferation of small lymphocytes. The patient is usually over 40 years old. Men are affected twice as often as women. CLL accounts for 25% of leukemias. It results in autoimmune hemolysis, infection and bone marrow failure. Radiotherapy, chemotherapy and supportive care are needed to treat CLL.
Myeloma is a neoplastic proliferation of plasma cells with diffuse bone marrow infiltration and focal osetolytic lesions. A monoclonal immunoglobulin band is seen on serum and urine electrophoresis. Peak age of myeloma is 70 years. Males and females are affected equally. There are three types of myeloma according to the main neoplastic product. They are IgA, IgG, and light chain disease. Bone pain, pathological fractures, lethargy, infection, amyloidosis, neuropathy, and hyperviscosity of blood are main features of myeloma. Adriamycin, bleomycin, cyclophosphamide, and melphalan are the common combined regimen used to treat myeloma.
What is the difference between Leukemia and Myeloma?
• Leukemias are lymphocyte and myeloid cell cancers while myeloma is a plasma cell cancer.
• Leukemias are common in younger people while myeloma occurs after 70 years usually.
• Leukemias are commoner in men than in women.
• There is an immunoglobulinemia in myeloma while there is none in leukemias.
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