Table of ContentsView AllTable of ContentsSymptomsCausesCML vs. AMLDiagnosisTreatmentPrevention
Table of ContentsView All
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Table of Contents
Symptoms
Causes
CML vs. AML
Diagnosis
Treatment
Prevention
Acute myeloid leukemia (AML)andchronic myeloid leukemia (CML)have key differences. The speed of disease progression in CML vs. AML is one way the two conditions are distinct, but they also differ in some of their symptoms, and in how they are diagnosed and treated.
This article will help you learn what sets AML apart from CML. It also discusses CML vs. AML treatment options.
Verywell / Jessica Olah
It’s not always easy to distinguish between acute and chronic myeloid leukemia based on symptoms alone. The two conditions can have similar symptoms, including:
However, there can also be differences as well. With acute myeloid leukemia, patients may also experience symptoms such as:
Meanwhile, those with chronic myeloid leukemia may experience symptoms such as:
Sometimes, people with CML don’t have any symptoms.
AML is the second most common type of leukemia, usually in adults. The five-year survival rate is 69% in those age 20 or younger and 27% in those older than 20.CML accounts for about 15% of all leukemias, about half affecting those age 64 and older. Five-year survival rates are about 72% today.
What Survival Rate Really Means With Cancer
Acute Myeloid Leukemia
With acute myeloid leukemia, a mutation in the stem cells causes morewhite blood cellsto be produced than are needed. These cells are immature (not maturing beyond the early blast stage) and lack the infection-fighting capabilities of fully developed white blood cells.
As the number of immature blast cells increases, this leaves less room for red blood cells (which carry oxygen) andplatelets(which help in clotting). When these healthy cells are crowded out, it gives rise to AML leukemia symptoms.
It is not known why this mutation develops, but it is known that both smoking and prolonged exposure to the chemical benzene might put you at increased risk.
Three other subtypes that can be divided into further categories include:
How Many AML Subtypes Are There?AML subtypes depend on the specific system used to classify them. A 2016 study of 1,540 people with AML identified at least 11 major types based on their genetic changes.
How Many AML Subtypes Are There?
AML subtypes depend on the specific system used to classify them. A 2016 study of 1,540 people with AML identified at least 11 major types based on their genetic changes.
Chronic Myeloid Leukemia
In many cases of chronic myeloid leukemia, some DNA between chromosomes 9 and 22 is partially swapped in a process known as translocation. In almost all CML patients, this makes chromosome 22 shorter than usual—something dubbed thePhiladelphia chromosome.
This also leads to the formation of the BCR-ABLoncogene, which produces a protein that causes CML cells to grow and divide uncontrollably. These DNA changes are not passed to you from your parents (inherited) but rather occur during your lifetime.
CML cells mature more than AML cells do. While these more closely resemble normal white blood cells, they don’t fight infection as well. They also end up crowding out normal cells from thebone marrow.
Without treatment, CML takes about three to four years to transition from the chronic to blast phase.
Comparing CML vs. AML
Besides distinct causes and differing symptoms, the speed of disease progression is different in AML than in CML. AML symptoms come on quickly over days to weeks. With CML, the symptoms come on much more slowly, over months to years.
The most important differences between the two conditions are as follows:
Slower disease progression
Accounts for just 15% of leukemias, more often affecting older adults
Symptoms include night sweats, unexplained weight loss
May appear on routine blood tests due to lack of symptoms
Treated with targeted therapy before other options
Rapid disease progression
Second most common leukemia, affecting both adults and children
Symptoms include bone pain, petechiae, shortness of breath
Blood and bone marrow tests focus on blast cell number and type
Treated with chemotherapy before other options
Determining whether you may have either AML or CML will mean undergoing a battery of tests. With CML, there may be no symptoms. Instead, it may be flagged during a routine checkup or a blood test done for something unrelated.
For both AML and CML, you can expect to undergo blood, bone marrow, and genetic tests such as the following:
AML Testing
Whendiagnosing AML, some factors that healthcare providers may look for in the lab samples include:
CML Testing
In looking for a case of CML, healthcare providers are on alert for:
As part of the diagnostic process, healthcare providers will determine the phase of the disease (in the case of a CML diagnosis) or classify the subtype (in the case of AML).
Finding the right treatment for your particular type of leukemia is key because approaches can vary.
AML Approaches
Induction therapytakes place right after diagnosis, aiming to put you into complete remission. In younger people, a combination of Cytosar-U (cytarabine) and Cerubidine (daunorubicin) or Idamycin (idarubicin) is commonly given.
Older adults with conditions that rule out the use of intensive chemotherapy may be given lower intensity therapies, such as:
These therapies may be used alone or in combination with Venclexta (venetoclax), a BCL2 inhibitor, or with IDH1 inhibitors such as Rezlidhia (olutasidenib) or Tibsovo (ivosidenib) if mutations are present.
As part of the therapy, particularly for those at higher risk of relapse, astem cell transplantis often suggested.
In some AML cases, targeted therapy aimed at specific genes or proteins or even the environment of the tissue itself may be an option. This can target mutations in genes such as IDH1, IDH2, and FLT3.
CML Therapy
The usual treatment for the majority of people with CML is targeted therapy, with other options such as chemotherapy, immunotherapy, and bone marrow (stem cell) transplantation used much less often than they were in the past.
CML is sometimes called the “good” cancer because CML treatments have advanced, including targeted therapy drugs. The targeted approach for CML patients takes aim at the BCR-ABLtyrosine kinaseenzyme, with the idea of inhibiting this protein.
When tyrosine kinase inhibitors are used, these keep the BCR-ABL enzyme from working and kills off CML cells. These usually come in pill form. Some tyrosine kinase inhibitors that may be offered to those with CML include the following:
Chemotherapy may also be a possibility in some CML cases with Droxia or Hydrea (hydroxyurea). This may be used initially to normalize blood cell levels and also reduce spleen size. The downside is that this alone does not prevent blasts from developing, and it also doesn’t reduce the number of cells with Philadelphia chromosome.
Heading off AML or CML before it develops can be an appealing idea. Unfortunately, for CML, there are no known lifestyle risk factors that can be altered.
Some rare cases of AML occur after a person has a different type of cancer that is treated with chemotherapy or radiation. The healthcare provider will weigh the need for treating this other cancer with the slightly increased risk that it may result in AML.
Summary
AML and CML are blood andbone marrow cancersthat affect the same lines of white blood cells. AML comes on suddenly as very immature cells crowd out normal cells in the bone marrow. CML comes on more slowly, with the CML cells growing out of control.
AML is vigorously treated upon detection with chemotherapy and stem cell transplantation. CML is primarily treated with targeted therapy, but may also be treated with chemotherapy, immunotherapy, or stem cell transplantation.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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