Leukemia: Types and Treatment

Author: Marisa Healy, BSN, RN and Katherine Okonak, MSW, LSW

Last Reviewed: February 24, 2026

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What is leukemia?

Leukemia is cancer of the blood or blood cells. It is classified by two factors:

How quickly the leukemia develops:
- It can develop quicky, called acute leukemia.
- It can develop more slowly, called chronic leukemia.
The type of white blood cells that are affected, either lymphoid or myeloid.

Cells affected by leukemia are made in your bone marrow. Bone marrow is the spongy area in the center of bones. Larger bones have more bone marrow. This means they make more cells. Larger bones are your femur (top part of your leg or thigh), your hip bones, and parts of your rib cage. Some cells in the bone marrow are still developing and are not yet mature. These cells are called “blasts.” Once the cell has matured, it moves out of the bone marrow and into the bloodstream. Your body knows when more cells are needed and makes them.

In leukemia, a certain type of blood cell does not work as it should, and your body makes too many of these cells. When looked at under a microscope, these cells look different than healthy cells. They do not work the way they should. Your body keeps making these non-working cells, leaving little space for healthy cells. This imbalance of healthy and unhealthy cells causes leukemia and its symptoms:

Fever or chills.
Fatigue and/or weakness that does not get better.
Frequent or severe infections.
Losing weight without trying.
Swollen lymph nodes.
Enlarged liver or spleen.
Easy bleeding or bruising.
Frequent nosebleeds.
Tiny red spots on your skin (petechiae).
Sweating a lot, especially at night.
Bone pain or tenderness.

Most cancers are staged based on where the cancer started, how big the tumor is, and where it has spread (metastasized). Leukemia is a cancer of the blood and is not staged like most cancers. Most leukemias are classified into types instead of stages. When deciding treatment for leukemia, your provider will look at:

Blood cell counts.
Your age.
If your liver or spleen is larger than normal.
If you have had any blood disorders or cancers in the past.
Any gene mutations (changes) you may have.

What are the types of leukemia?

There are a few subtypes of leukemia, based on which cells are affected in your bone marrow. Some of them are staged and others are not.

Acute Lymphocytic Leukemia (ALL)

ALL is classified using the World Health Organization (WHO) system. This system is based on the type of cells it starts in:

B-cell ALL (beginning in immature B-cells).
T-cell ALL (beginning in immature T-cells).

It is further classified depending on the changes seen in the genes and chromosomes of the cells. Talk with your provider about the classification of your leukemia.

Acute Myelogenous Leukemia (AML)

AML may also be called acute myelocytic leukemia, acute granulocytic leukemia, or acute non-lymphocytic leukemia. The French-American-British (FAB) classification and the newer World Health Organization (WHO) system are used to classify AML. The World Health Organization system classifies AML as:

AML with certain genetic abnormalities (gene or chromosome changes).
AML with myelodysplasia-related changes.
AML related to previous chemotherapy or radiation.
AML not otherwise specified (This includes cases of AML that don’t fall into one of the above groups).
Myeloid proliferations related to Down syndrome.
Undifferentiated and biphenotypic acute leukemias are leukemias that have both lymphocytic and myeloid features. They are sometimes called mixed phenotype acute leukemias (MPALs).

Talk with your provider about the classification of your leukemia.

Chronic lymphocytic leukemia (CLL)

There are two different staging systems for CLL:

Rai Staging System

This system is based on results of blood tests (especially the number of white blood cells) and physical exam.

In each stage, there is lymphocytosis. Lymphocytosis is when there are too many white blood cells (WBC) in your body. The extra WBCs are found in your blood and bone marrow.

Stage 0: Lymphocytosis with no enlargement of lymph nodes, spleen, or liver. Red blood cell and platelet counts are almost normal.
Stage I (one): Lymphocytosis with enlarged lymph nodes. The spleen and liver are not affected. Red blood cell and platelet counts are almost normal.
Stage II (two): Lymphocytosis with an enlarged spleen and in some cases an enlarged liver. Lymph nodes may or may not be enlarged. Red blood cell and platelet counts are almost normal.
Stage III (three): Lymphocytosis plus enlarged lymph nodes. The spleen or liver may or may not be enlarged. Red blood cell count is low, and platelets are near normal.
Stage IV (four): Lymphocytosis plus enlarged lymph nodes, spleen, or liver. Red blood cell counts may be low or near normal and the platelet count is low.

Each stage is also put into a risk group that helps decide which treatments are best:

Stage 0: Low risk.
Stage I and II: Intermediate (middle) risk.
Stage III and IV: High Risk.

Binet Staging System

This system is based on the number of affected lymphoid tissue groups and if you have anemia (not having enough healthy red blood cells) or thrombocytopenia (low platelets).

Lymphoid tissue groups are in the neck lymph nodes, groin lymph nodes, underarm lymph nodes, spleen, and liver.

Stage A: Fewer than 2 areas of lymphoid tissue are enlarged, no anemia, and no thrombocytopenia.
Stage B: 3 or more areas of enlarged lymphoid tissue, no anemia, and no thrombocytopenia.
Stage C: Any number of lymphoid areas are enlarged, and there is anemia and thrombocytopenia.

Chronic myelogenous leukemia (CML)

CML is broken down into three phases. The phases are based mainly on the number of immature white blood cells (blasts) in your blood or bone marrow. There is no set system for CML, but common classifications (by the World Health Organization) are:

Chronic: Less than 10% (10 out of 100) blasts in your blood or bone marrow. This phase often causes mild symptoms, if any. Most patients are diagnosed in the chronic phase.
Accelerated: 15% to 19% (15 to 19 out of 100) blasts in your blood.
Blast (also called acute phase or blast crisis): 20% (20 out of 100) or more blast cells in your blood. This is the most aggressive phase of the disease. The blast cells have spread to tissues and organs outside your bone marrow. Symptoms may include fever, poor appetite, enlarged spleen, and weight loss.

How is leukemia treated?

Treatment for leukemia depends on many factors, such as your age and overall health, the type of leukemia you have, and if it has spread to other parts of your body. Your treatment may include:

Talk with your provider about the subtype of leukemia you have, which stage or phase it is, and what the best treatment options are for you. You can read more about each leukemia subtype at OncoLink.org.