lymphocytic leukemia
Meaning of lymphocytic leukemia: One name covers two diseases that differ in nearly everything except the cell they come from: pace, age and urgency.
Definition of lymphocytic leukemia
Lymphocytic leukemia is cancer of the blood and bone marrow in which lymphocytes, one of the two main families of white blood cell, multiply abnormally and crowd out healthy blood cells. It sits opposite myeloid leukemia, which begins in the other family. The name covers two separate diseases, an acute form and a chronic form.
What does lymphocytic point to?
Blood cells all descend from stem cells in the bone marrow, and those stem cells branch early into two lines. The lymphoid line produces lymphocytes, the B, T and natural killer cells of the immune system. The myeloid line produces red cells, platelets and the remaining white cells. A leukemia is named for the line it arose from, so lymphocytic leukemia and acute myeloid leukemia are diseases of different cells that merely share a home. The distinction is not cosmetic, since the two lines respond to different drugs, and establishing which line is involved is one of the first steps once leukemia is suspected.
How do the acute and chronic forms differ?
| Feature | Acute | Chronic |
|---|---|---|
| Cell that accumulates | Immature blast that never matured | Mature looking cell that works poorly |
| Pace | Weeks | Years |
| Age most affected | Children, with a second rise in older adults | Older adults |
| How it is usually found | Symptoms of failing marrow | Often an unexpected blood count |
The words acute and chronic do more work here than describing speed. In an acute leukemia the cells are stalled at an early stage and cannot mature, so they pile up without ever doing a lymphocyte's job. In a chronic leukemia the cells look almost normal and survive far too long rather than dividing furiously. Pace follows from that difference rather than defining it.
Why does the label change what happens next?
Acute lymphocytic leukemia, also called acute lymphoblastic leukemia, is the commonest cancer of childhood and is treated as soon as it is confirmed, through a long program of drugs. Chronic lymphocytic leukemia is frequently picked up on a blood count ordered for something else, and a person without symptoms or falling counts may be monitored for a long stretch before treatment is considered at all. Further testing sorts the acute form by whether the cells are of B or T type, which shapes the regimen chosen, and the same marrow examination that confirms the diagnosis supplies the genetic detail used to judge how the disease is likely to behave.
Used in a sentence
Laboratory findings raised concern for a lymphocytic leukemia, prompting bone marrow evaluation.
Good to know
Acute and chronic lymphocytic leukemia are often confused because they share a name, despite differing greatly in how quickly they progress and which age group they typically affect.
Word origin
Where “lymphocytic leukemia” comes from
Formed from Greek leukos, meaning white, and haima, meaning blood, since the disease was first recognized by a marked excess of white blood cells.