Acute Myeloid Leukemia vs Acute Lymphoblastic Leukemia
Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Acute Myeloid Leukemia vs Acute Lymphoblastic Leukemia at a glance
- Acute Myeloid Leukemia: Clonal expansion of myeloid blasts in marrow and blood — pancytopenia plus circulating blasts; APL subtype is a hemorrhagic emergency.
- Acute Lymphoblastic Leukemia: Clonal expansion of lymphoid blasts — most common pediatric cancer; CNS sanctuary and Philadelphia chromosome subtype distinctive.
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Side-by-side comparison
| Feature | Acute Myeloid Leukemia | Acute Lymphoblastic Leukemia |
|---|---|---|
| At a glance | Clonal expansion of myeloid blasts in marrow and blood — pancytopenia plus circulating blasts; APL subtype is a hemorrhagic emergency. | Clonal expansion of lymphoid blasts — most common pediatric cancer; CNS sanctuary and Philadelphia chromosome subtype distinctive. |
| Classic presentation | Older adult with pancytopenia, fatigue, petechiae, and Auer rods on blast smear. APL: severe DIC with intracranial or pulmonary hemorrhage at presentation.;… | Child 2-5 years old with bone pain, refusal to walk, pallor, petechiae, hepatosplenomegaly, and circulating lymphoblasts.; Pancytopenia symptoms: fatigue,… |
| Workup / key labs | ≥20% myeloid blasts in bone marrow or peripheral blood (WHO 5th edition); or any blast percentage with recurrent cytogenetic abnormality t(15;17), t(8;21),… | ≥20% lymphoblasts in bone marrow or peripheral blood with lymphoid immunophenotype (B-cell or T-cell precursor markers, TdT positive) — distinct from mature… |
| Imaging | CXR if pulmonary symptoms; chest CT for febrile neutropenia evaluation; Echocardiogram before anthracycline therapy; CT or MRI head if neurologic symptoms | Chest X-ray and CT chest — mediastinal mass especially in T-ALL (do BEFORE sedation/anesthesia to assess airway compression risk); Testicular ultrasound if… |
| First-line treatment | Induction chemotherapy '7+3': cytarabine (continuous infusion × 7 days) + anthracycline (daunorubicin or idarubicin × 3 days) — standard for fit patients;… | Induction (4 weeks): vincristine + corticosteroid (prednisone/dexamethasone) + anthracycline (daunorubicin) + asparaginase (PEG-asparaginase or Erwinia);… |
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