Acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) are cancers of the blood and bone marrow.

In AML, the bone marrow makes too many myeloblasts, red blood cells, and platelets. Myeloblasts are a type of white blood cell.

In ALL, the bone marrow makes too many lymphocytes, which are another type of white blood cell.

This article outlines the difference between AML and ALL, as well as their associated risk factors and symptoms. It also provides information about diagnosis, treatment, and survival rates.

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AML and ALL are both cancers of the blood and bone marrow.

The main difference between the two is that AML affects the production of myeloblasts, red blood cells, and platelets, whereas ALL mainly affects the production of lymphocytes.

What are myeloblasts?

Myeloblasts are a type of precursor white blood cell that mature into either neutrophils, basophils, or eosinophils. These types of white blood cell engulf and dissolve different pathogens, such as bacteria and viruses.

What are lymphocytes?

Lymphocytes are another type of white blood cell. There are two main types: B lymphocytes and T lymphocytes.

B lymphocytes produce antibodies, whereas T lymphocytes help kill tumor cells and regulate the immune response.

Certain factors can increase a person’s risk of developing either AML or ALL. Below, we outline some of the risk factors experts associate with each of these conditions.

AML

AML risk factors include:

ALL

ALL is more common in the following groups of people:

  • children and older adults
  • males
  • people who are white
  • people who smoke
  • people who have a family history of ALL

Other risk factors for ALL include:

  • certain genetic conditions
  • human T-cell lymphoma/leukemia virus-1
  • Epstein-Barr virus
  • radiation exposure
  • benzene exposure

Both ALL and AML are very serious conditions that develop rapidly.

According to a 2021 review, AML is the most common type of leukemia among adults, accounting for around 80% of all cases.

Authors of the review observe that age plays an important role in survival rates for AML. Following treatment, around 15% of people above the age of 60 years will recover, compared with 40% of people below the age of 60 years.

According to another 2021 review, ALL is most common among children aged 2–10 years. People who are younger than 30 years of age are more likely to experience successful treatment than those who are older. Also, around 30% of adults with ALL fully recover.

AML and ALL are both acute types of leukemia, and their symptoms are similar.

Generally, symptoms of AML and ALL include:

Many of these symptoms overlap with other, less serious conditions. However, anyone who is concerned about symptoms should consult a doctor, especially if they are experiencing a cluster of symptoms.

Symptoms of AML and ALL are similar, and therefore doctors need to perform several tests and physical exams before reaching a diagnosis.

AML

To diagnose AML, a doctor will first request a blood smear test to check for abnormalities in the red and white blood cells, and platelets. They may then request a bone marrow biopsy to check for abnormal cells in the bone marrow.

If these tests indicate AML, the doctor may then order cytometry and cytogenetic tests to determine the type of AML a person has.

Cytometry assesses characteristics of cells, such as:

  • cell size
  • cell morphology
  • cell DNA
  • the presence or absence of specific proteins in or on the cell
  • the number of cells present in the sample

Cytogenetic tests assess changes to chromosomes within a sample. This may include:

  • broken chromosomes
  • rearranged chromosomes
  • missing chromosomes
  • extra chromosomes

ALL

If a person is presenting with symptoms of ALL, a doctor will request a complete blood count to check the numbers of different blood cells in the blood. They will also measure levels of electrolytes and urea in the blood.

A doctor may also request imaging scans of the abdomen and pelvis to help determine the stage of the cancer.

In some cases, a doctor may be concerned that the cancer has spread to the central nervous system. A person may then receive a lumbar puncture to check for the presence of lymphoblasts in their spinal fluid.

Treatment options for AML and ALL are similar.

In both instances, a person will usually receive induction therapy. This is the first-line treatment that aims to put the disease into remission. It typically consists of chemotherapy.

If a person goes into remission after induction therapy, they will begin consolidation therapy. This is the next stage of treatment that kills off any remaining cancer cells in the body in order to help maintain disease remission.

Consolidation therapy for AML

Consolidation therapy for AML may consist of high-dose chemotherapy, hematopoietic cell transplantation (HCT), or both.

HCT involves transplanting the abnormal blood-forming stem cells with healthy blood-forming stem cells from the person’s own body or from a donor.

Consolidation therapy for ALL

Consolidation therapy for ALL typically consists of multidrug chemotherapy.

In some cases, a doctor may recommend stem cell therapy (SCT). Like HCT, SCT involves replacing the abnormal blood-forming stem cells with healthy ones either from the person’s own body or from a donor.

Due to improvements in chemotherapy treatment, SCT for ALL is becoming less common.

Additional treatments

People with leukemia may also receive other types of treatment, such as:

The types of additional treatment a person receives will depend on several factors, including:

  • the person’s age
  • their white blood cell count
  • the type of leukemia they have
  • whether they had an underlying condition that triggered the leukemia
  • whether they have received cancer treatments in the past

Below, we outline the relative survival rates for AML and ALL.

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition is going to affect them.

AML

According to the National Cancer Institute (NCI), between the years 2011 and 2017, the 5-year relative survival rate for AML in the United States was 29.5%.

This means that 29.5% of people in the U.S. who received an AML diagnosis went on to live 5 years or longer following their initial diagnosis.

Between 2016 and 2018, the lifetime risk of developing AML was 0.5%. The NCI estimates that, during the same time frame, 66,988 people were living with the condition.

ALL

The 5-year relative survival rate for ALL is 69.9%.

Between 2016 and 2018, the lifetime risk of developing ALL was 0.1%. According to the NCI estimates, during the same time frame, 103,536 people were living with ALL.

A person who has recently received a diagnosis of AML or ALL may want to find out more about their condition and its treatment.

Below are some questions individuals may want to ask a doctor or wider medical team:

  • Can you explain my diagnosis to me in more detail?
  • Can you explain my test results in greater detail?
  • What subtype of AML or ALL do I have?
  • Who are the specialists that will be looking after me?
  • What are my treatment options?
  • Can you cure my leukemia, or will treatment focus on managing my symptoms?
  • What are the side effects of my treatment?
  • Will the treatment prevent me from working?

Both AML and ALL are acute types of leukemia. AML causes the body to produce too many myeloblasts, platelets, and red blood cells. By contrast, ALL increases the production of lymphocytes.

Also, both AML and ALL are acute leukemias, and therefore both have similar symptoms. These may include flu-like symptoms, weakness, and fatigue.

Typically, the first-line treatment for both AML and ALL is chemotherapy, which aims to put the disease into remission. Follow-up consolidation therapy can help destroy any remaining cancer cells and maintain remission.

A person can ask a doctor for specific information on the type of leukemia they have and the treatment options available to them.