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Questions and answers

How many types are there?

Leukemia is not one disease but a family of diseases. Knowing the type is the key to understanding treatment.

Last updated: ~2 min read
Four main types: speed and cell line
Figure 1.Four main types: speed and cell line

01Short answer

There are four main types of leukemia: acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL). They are told apart by two questions: which cell line is affected (myeloid or lymphoid) and how fast the disease moves (acute or chronic). There are also rarer types: acute promyelocytic leukemia (APL), hairy cell leukemia, chronic myelomonocytic leukemia and others. Within each type, genetic subtypes make treatment even more individual.

02Simple explanation

First question: is the affected cell from the myeloid line (red cells, platelets, neutrophils) or the lymphoid line (lymphocytes)?

Second question: does the disease move acutely (fast, over weeks) or chronically (slowly, over months or years)?

The answers give the four main types.

03Scientific explanation

Modern classifications (the WHO 5th edition and the International Consensus Classification) group leukemias not only by how the cells look but also by their genetic changes.

For example, NPM1, FLT3 and CBF changes in AML, the Philadelphia chromosome in ALL, and TP53 and IGHV status in CLL affect outlook and treatment choice.

04What happens in the body?

The four main types

AML is the most common acute leukemia in adults. ALL is the most common cancer in children but also occurs in adults. CML usually progresses slowly and is linked to the BCR::ABL1 change. CLL is the most common adult leukemia in Western countries, mostly in older people.

Rare types

APL is a special form of AML that needs urgent treatment because of bleeding risk. Hairy cell leukemia is a slow B-cell disease. Chronic myelomonocytic leukemia, large granular lymphocytic leukemia and others are less common.

Two branches: myeloid and lymphoid
Figure 2.Two branches: myeloid and lymphoid

Why the subtype matters

Two leukemias with the same name can be very different genetically. So the doctor makes the diagnosis together with the genetic results, not by type name alone, and chooses the plan accordingly.

Main types and rare types
Figure 3.Main types and rare types

05How the type is worked out

The doctor pins down the type in four steps.

Which line — Myeloid or lymphoid cells.1Which lineMyeloid or lymphoid cells.
Which speed — Acute or chronic course.2Which speedAcute or chronic course.
Genetic subtype — Chromosome and gene changes.3Genetic subtypeChromosome and gene changes.
Personal plan — Treatment is matched to the type.4Personal planTreatment is matched to the type.
The exact nameKnow the full name of your diagnosis.
The right informationRead about your own type.

06Key points at a glance

TopicIn brief
The four main typesAML is the most common acute leukemia in adults. ALL is the most common cancer in children but also occurs in adults. CML usually progresses slowly and is linked to the BCR::ABL1 change. CLL is the most common adult leukemia in Western countries, mostly in older people.
Rare typesAPL is a special form of AML that needs urgent treatment because of bleeding risk. Hairy cell leukemia is a slow B-cell disease. Chronic myelomonocytic leukemia, large granular lymphocytic leukemia and others are less common.
Why the subtype mattersTwo leukemias with the same name can be very different genetically. So the doctor makes the diagnosis together with the genetic results, not by type name alone, and chooses the plan accordingly.

07Key terms

Myeloid
The cell line that makes red cells, platelets and granulocytes.
Lymphoid
The cell line that makes lymphocytes.
Subtype
A finer grouping based on a genetic change.

08Key points

  • Four main types: AML, ALL, CML, CLL.
  • There are rarer types too.
  • The type depends on cell line and speed.
  • Genetics makes the plan individual.

09Frequently asked questions

Can one type turn into another?

Sometimes: for example, untreated CML can move into an acute phase, and MDS can become AML.

Is childhood leukemia the same as adult leukemia?

The types can be the same, but the course and treatment often differ.

How can I know my exact type?

Ask your doctor for the written diagnosis and the genetic results.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can one type turn into another?

  2. Is childhood leukemia the same as adult leukemia?

  3. How can I know my exact type?

My questions

12Sources

  1. National Cancer Institute (NCI). Leukemia—Patient Version
  2. National Cancer Institute (NCI). Adult Acute Myeloid Leukemia Treatment (PDQ®) – Patient Version
  3. National Cancer Institute (NCI). Adult Acute Lymphoblastic Leukemia Treatment (PDQ®) – Patient Version
  4. National Cancer Institute (NCI). Chronic Myeloid Leukemia Treatment (PDQ®) – Patient Version
  5. National Cancer Institute (NCI). Chronic Lymphocytic Leukemia Treatment (PDQ®) – Patient Version
  6. MedlinePlus (U.S. National Library of Medicine). Leukemia
  7. NHS. High temperature (fever) in adults
  8. NHS. How to wash your hands
  9. Cancer Research UK. Coping emotionally with cancer
  10. National Cancer Institute (NCI). When Someone You Love Is Being Treated for Cancer (booklet)
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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