Leukaemia, lymphoma and multiple myeloma are all blood cancers, but they do not begin in the same cells or behave in the same way. The familiar shortcut of “blood, lymph nodes and bone” only tells part of the story because their symptoms, locations and test results can overlap.
Key takeaways • Leukaemia involves blood-forming cells, lymphoma develops from lymphocytes and multiple myeloma develops from plasma cells. • Their symptoms can overlap, so these signs alone cannot tell you which type is present. • Diagnosis also differs. A tissue biopsy is central to diagnosing lymphoma, while blood and bone marrow tests often have a larger role in leukaemia and myeloma. • The specific diagnosis matters because it helps the treating team decide whether they need to provide treatment, monitoring or more testing. |
Leukaemia, lymphoma and multiple myeloma at a glance
Two details make the comparison easier: the cell involved and where the disease usually appears.
Blood cancer | Where it starts | What mainly makes it different |
Leukaemia | Blood-forming cells, usually in the bone marrow | Often affects how normal blood cells are made and may also involve the blood |
Lymphoma | Lymphocytes, a type of white blood cell | Commonly involves lymph nodes or other lymphatic tissue but can also occur elsewhere |
Multiple myeloma | Plasma cells in the bone marrow | Can affect normal blood-cell production and may also cause bone, kidney or calcium-related problems |
Where each blood cancer develops and what it affects
The cell involved shapes where the disease develops and the problems it may cause.
Leukaemia starts in blood-forming cells
Leukaemia is a group of cancers involving blood-forming cells in the bone marrow. In many forms, abnormal cells are also found in the blood. They can interfere with the marrow’s ability to make healthy red cells, white cells and platelets.
Leukaemia is not one single disease. Some types develop quickly, while others grow more slowly. Doctors also classify leukaemia by the type of blood-forming cell it starts in. This is why there are different types, such as acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL) and chronic myeloid leukaemia (CML).
Lymphoma starts in lymphocytes
Lymphoma develops from lymphocytes, a type of white blood cell, and commonly involves lymph nodes or other lymphatic tissues. It is not limited to lymph nodes. Some lymphomas also occur in other organs or involve bone marrow. Bone marrow involvement does not mean the disease has become leukaemia.
The difference between leukaemia and lymphoma is not only about where the cancer is found. Some leukaemias can also affect the lymph nodes or spleen. CLL and SLL show this clearly. They are the same disease, but CLL is mainly found in the blood and bone marrow, while SLL is mainly found in the lymph nodes.
There are many types of lymphoma. The two main groups are Hodgkin lymphoma and non-Hodgkin lymphoma. Some types grow slowly, while others grow more quickly. Knowing which type it is helps doctors understand how the disease may behave and plan treatment.
Multiple myeloma starts in plasma cells
Multiple myeloma is a blood cancer that develops from plasma cells in the bone marrow. Plasma cells are immune cells that normally make antibodies. In myeloma, abnormal plasma cells build up and can interfere with normal blood-cell production. They often produce an abnormal protein that can be measured in blood or urine.
Multiple myeloma can affect more than the bones. Kidney function, calcium levels and normal blood-cell production may also be affected.
Unlike leukaemia, which can arise from different blood-forming cell lines, multiple myeloma specifically develops from plasma cells. It is not a subtype or stage of leukaemia.
Symptoms overlap, but some patterns are more typical
Symptoms overlap because more than one of these cancers can affect normal blood-cell production or immune function. Tiredness, infections, fever or changes in blood counts may occur in more than one type.
Leukaemia: changes in normal blood-cell production may cause tiredness or breathlessness from anaemia, repeated infections, or easier bruising and bleeding.
Lymphoma: swollen lymph nodes are common, although symptoms depend on where the lymphoma is located. Some people may also have fever, drenching night sweats or unexplained weight loss.
Multiple myeloma: bone or back pain may be more prominent. Anaemia, kidney problems or changes in calcium can also occur.
Early signs and symptoms of blood cancer are not specific enough to identify a type on their own. Doctors interpret them alongside examination and test results.
How the diagnosis differs between the three
Some tests overlap, but the route to diagnosis differs according to the disease doctors suspect.
Blood tests are an early part of leukaemia assessment
A complete blood count and examination of blood cells may show abnormalities that need more testing. The next tests depend on the type of leukaemia being considered and may include bone marrow or specialised laboratory testing.
A tissue biopsy is central to diagnosing lymphoma
Blood tests may show changes, but they do not diagnose lymphoma on their own. Diagnosis usually depends on a biopsy of an affected lymph node or other tissue so that the cells and tissue pattern can be examined. Imaging may then show where disease is present.
Myeloma is diagnosed using blood, marrow and imaging tests
Blood or urine tests can detect an abnormal protein made by myeloma cells. Bone marrow assessment and imaging help confirm the diagnosis and show how the disease is affecting the body. Blood tests also check for problems such as anaemia, kidney impairment or changes in calcium.
After a blood cancer diagnosis, what happens next depends on the disease that has been identified.
Treatment depends on the specific diagnosis
Knowing that someone has leukaemia, lymphoma or myeloma is not enough to choose treatment. AML and CLL, for instance, are both leukaemias but can behave very differently. Treatment decisions depend on the disease identified, its biological features and the person’s overall health.
Some acute leukaemias need treatment soon after diagnosis, while certain chronic leukaemias may initially be monitored. Some slower-growing lymphomas can also be monitored before treatment is needed. Myeloma treatment depends on whether active disease is present and on other findings from the assessment.
If you already have a diagnosis
If you have been diagnosed with blood cancer and want to discuss supportive care alongside your oncology treatment, you can schedule a consultation with Dr Tarang Krishna. This does not replace care from your haematology or oncology team.
Read more from the blood cancer series
What Is Blood Cancer? Early Signs, Symptoms and When to Get Checked
How Is Blood Cancer Treatment Decided? Type, Stage, Age, Overall Health and Other Factors
Blood Cancer Diagnosis: Blood Tests, Bone Marrow Evaluation and What Happens Next
References
Alaggio, R., Amador, C., Anagnostopoulos, I. et al. (2022) ‘The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms’, Leukemia, 36, pp. 1720–1748.
American Cancer Society (n.d.) Tests for Non-Hodgkin Lymphoma.
Blood Cancer UK (2025) Blood cancer symptoms and signs. Last reviewed November 2025.
Campo, E. et al. (2022) ‘The International Consensus Classification of Mature Lymphoid Neoplasms: a report from the Clinical Advisory Committee’, Blood, 140(11), pp. 1229–1253.
National Cancer Institute (n.d.) Blood cancer. NCI Dictionary of Cancer Terms.
National Cancer Institute (n.d.) Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version.
Rajkumar, S.V. (2024) ‘Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management’, Am J Hematol. 2024 Sep;99(9):1802-1824. doi: 10.1002/ajh.27422. Epub 2024 Jun 28.
