Leukemia

ALL is an aggressive form of leukemia that develops from immature lymphoid stem cells. It can impact adult and pediatric patients. Learn more about childhood ALL and adult ALL. 

AML is an aggressive type of leukemia developing from lymphoid stem cells. Like ALL, both adults and children can develop AML, though the prognosis is different for the two groups. Learn more about childhood AML and adult AML. 

CLL is a slow-growing type of leukemia. It develops from lymphoid stem cells that are further along in their development than ALL cells. This disease primarily impacts older patients and is nearly unheard of in children. Learn more about CLL.

CML grows from more mature myeloid stem cells. It is a slower growing form of leukemia. Treatment for the disease has advanced rapidly over the past few decades. It is rare in children and is usually diagnosed in older adults. Learn more about CML.

B-PLL is a rare leukemia developing from B cells, a type of white blood cell, that rapidly multiply. The disease can be difficult to diagnose and is often confused with other bone marrow and blood cancers, including different leukemias and lymphomas. 

The disease is typically aggressive, though around 10% of patients do not have any symptoms when they are diagnosed. Instead of immediate treatment, in some cases doctors recommend active surveillance, in which the disease is closely monitored. Treatment begins when the disease advances to a set point. 

When treatment is needed, options include chemotherapy and targeted therapy.  

BPDCN is an aggressive subtype of acute leukemia that impacts approximately 500 to 1,000 people in the U.S. each year. Though it can affect people of any age, the disease is most common among older patients, with about half of new diagnoses coming in patients age 70 or older. Historically, it has been associated with poor survival rates.

BPDCN is a cancer of a specific type of cell known as plasmacytoid dendritic cells. This rare type of immune system cell is usually found in the skin, bone marrow, blood, lymph nodes and spleen. As a result, symptoms usually can impact these areas. Skin lesions are the most common BPDCN symptom. These can show up anywhere on the body but often appear on the arms, legs, face and neck. Other symptoms include low counts of healthy blood cells and swollen lymph nodes.

Traditionally, BPDCN has been treated with chemotherapy, while younger, fitter patients have been given the option of a stem cell transplant. The Food and Drug Administration has recently approved a new targeted therapy drug that attacks CD123, a molecule commonly found on the surface of BPDCN cells. This targeted therapy is now considered a standard treatment for the disease. Learn more about BPDCN.

CMML is a rare, slow-growing type of leukemia that mainly impacts people in their 60s and older. Patients with CMML have low counts of healthy blood cells and high counts of diseased monocytes. Monocytes are a type of white blood cell that helps other immune system cells respond to infection. They also surround and consume bacteria that invade the body.  

About 1,100 CMML cases are diagnosed in the U.S. each year. In 15% to 30% of patients, the disease will progress to acute myeloid leukemia. 

CMML is typically treated with stem cell transplantation, which can cure the disease, or chemotherapy, which can’t cure the disease but can kill cancer cells and make room for healthy blood cells to develop. To address low blood counts, patients can also receive blood transfusions and drugs that stimulate the growth of healthy blood cells. 

In hairy cell leukemia, lymphoid stem cells produce too many diseased B cells. These cells have thin growths on their surface that look like hairs, giving the disease its name. The disease typically is diagnosed in patients age 50 and older and is more likely to arise in males. 

Hairy cell leukemia is typically slow to develop and progress. In some cases, it may never progress at all. Because of this, doctors often recommend active surveillance in which they closely monitor the disease. Other treatments include chemotherapy, immunotherapy and targeted therapy. 

Juvenile myelomonocytic leukemia (JMML) is a rare type of leukemia, mostly found in children age 4 and younger. In JMML, the diseased cells are monocytes, a type of white blood cell. JMML is faster growing than chronic leukemia and slower growing than acute. It shares many symptoms with other types of leukemia, including a pale complexion, fever and infections.  

Since JMML cells gather in certain organs, symptoms can also include an enlarged spleen and difficulty breathing caused by cancer cells accumulating in the lungs. A stem cell transplant is the recommended treatment for JMML, though about half of patients who undergo a successful transplant relapse. 

LGLL is a rare leukemia that develops from mature T cells or natural killer (NK) cells. Both are lymphocytes, white blood cells that help fight disease. 

In LGLL, the diseased T cells or NK cells begin to multiply rapidly, crowding out healthy cells. 

This leukemia is primarily diagnosed in older patients. In about 20% of cases, the patient also has an autoimmune disorder such as rheumatoid arthritis.  

Though the NK cell version can be more aggressive than the T cell version, LGLL in general is slow growing. Because of this, doctors may recommend active surveillance, in which the disease is closely monitored, instead of immediate treatment. Treatment begins when the disease advances to a set point. 

Because LGLL involves the overproduction of immune system cells, it is often treated with drugs meant to suppress the immune system. Chemotherapy is another treatment option. Patients are also given medicines to treat cytopenias, or low counts of healthy blood cells. 

T-cell prolymphocytic leukemia is an aggressive, extremely rare form of leukemia involving T-lymphoid stem cells. 

The cause of T-PLL is not known, but recent research has uncovered several chromosome and genetic abnormalities associated with the disease. These abnormalities can be used to help diagnose T-PLL and could lead to the development of new treatments for the disease.

Much like CLL, T-PLL can be slow growing when it is first diagnosed. In most cases, though, it progresses to a more advanced, aggressive disease. Symptoms include high white blood cell counts; enlarged lymph nodes, liver and spleen; rashes; and an accumulation of fluid around the lungs and heart.

The recommendation for early, slow-growing T-PLL is active surveillance. During this phase, the patient does not receive treatment, but is closely monitored for signs that the disease is advancing. When these signs develop, T-PLL needs to be treated rapidly, often in the hospital.  

While there are no medications specifically approved for T-PLL, a monoclonal antibody drug produces a high response rate. Doctors recommend a stem cell transplantation for patients who are in remission and eligible for the procedure.