Acute Myeloid Leukemia vs Chronic Myeloid Leukemia
Acute Myeloid Leukemia and Chronic Myeloid 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 Chronic Myeloid 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.
- Chronic Myeloid Leukemia: Myeloproliferative neoplasm defined by the Philadelphia chromosome (BCR-ABL1) — transformed by targeted TKI therapy into a chronic, manageable disease.
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Side-by-side comparison
| Feature | Acute Myeloid Leukemia | Chronic Myeloid Leukemia |
|---|---|---|
| At a glance | Clonal expansion of myeloid blasts in marrow and blood — pancytopenia plus circulating blasts; APL subtype is a hemorrhagic emergency. | Myeloproliferative neoplasm defined by the Philadelphia chromosome (BCR-ABL1) — transformed by targeted TKI therapy into a chronic, manageable disease. |
| Classic presentation | Older adult with pancytopenia, fatigue, petechiae, and Auer rods on blast smear. APL: severe DIC with intracranial or pulmonary hemorrhage at presentation.; Pancytopenia symptoms: fatigue, dyspnea, pallor (anemia); easy bruising, petechiae, mucosal bleeding (thrombocytopenia); fever, recurrent infections (neutropenia); Constitutional:… | Middle-aged adult with marked leukocytosis (often 100-500K), left-shifted granulocytosis with all stages of myeloid maturation, basophilia, and splenomegaly.; Often asymptomatic — diagnosed on incidental leukocytosis (~40-50% of cases); Fatigue, malaise, weight loss, low-grade fever, night sweats (constitutional symptoms); Early… |
| 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), inv(16)/t(16;16). APL diagnosed by t(15;17) PML-RARA or PML-RARA fusion.; CBC — anemia, thrombocytopenia; WBC may be high, normal, or low; circulating blasts often visible;… | BCR-ABL1 fusion (by cytogenetics t(9;22), FISH, or PCR) in a patient with myeloproliferative features. Phase determined by blast count and clinical criteria.; CBC — marked leukocytosis (often 100-500K), thrombocytosis common, mild anemia variable; eosinophilia and BASOPHILIA characteristic; Peripheral smear — left-shifted… |
| Imaging | CXR if pulmonary symptoms; chest CT for febrile neutropenia evaluation; Echocardiogram before anthracycline therapy; CT or MRI head if neurologic symptoms | Abdominal exam / ultrasound to document spleen size; Echocardiogram baseline before nilotinib/ponatinib (cardiovascular risk) |
| First-line treatment | Induction chemotherapy '7+3': cytarabine (continuous infusion × 7 days) + anthracycline (daunorubicin or idarubicin × 3 days) — standard for fit patients; Addition of midostaurin for FLT3-mutated AML (RATIFY trial); gilteritinib for FLT3-mutated relapsed/refractory; Older or unfit patients: venetoclax (BCL-2 inhibitor) + hypomethylating… | Tyrosine kinase inhibitor (TKI) — imatinib, dasatinib, nilotinib, bosutinib (first-line options); ponatinib for T315I mutation or failure of multiple TKIs; Imatinib (Gleevec) — first-generation, well-tolerated, long-term safety data; standard initial therapy in many settings; Second-generation TKIs (dasatinib, nilotinib, bosutinib)… |
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