Blood Cancers

Source:  American Society of Hematology

 

Blood cancers affect the production and function of your blood cells. Most of these cancers start in your bone marrow where blood is produced. Stem cells in your bone marrow mature and develop into three types of blood cells: red blood cells, white blood cells, or platelets. In most blood cancers, the normal blood cell development process is interrupted by uncontrolled growth of an abnormal type of blood cell. These abnormal blood cells, or cancerous cells, prevent your blood from performing many of its functions, like fighting off infections or preventing serious bleeding.

There are three main types of blood cancers:

Leukemia, a type of cancer found in your blood and bone marrow, is caused by the rapid production of abnormal white blood cells. The high number of abnormal white blood cells is not able to fight infection, and they impair the ability of the bone marrow to produce red blood cells and platelets.

Lymphoma is a type of blood cancer that affects the lymphatic system, which removes excess fluids from your body and produces immune cells. Lymphocytes are a type of white blood cell that fight infection. Abnormal lymphocytes become lymphoma cells, which multiply and collect in your lymph nodes and other tissues. Over time, these cancerous cells impair your immune system.

Myeloma is a type of blood cancer that specifically targets your plasma cells. Plasma cells are white blood cells that produce disease- and infection-fighting antibodies in your body. Myeloma cells prevent the normal production of antibodies, leaving your body’s immune system weakened and susceptible to infection.

 

Leukemia

Leukemia is a type of cancer found in your blood and bone marrow and is caused by the rapid production of abnormal white blood cells. These abnormal white blood cells are not able to fight infection and impair the ability of the bone marrow to produce red blood cells and platelets.

Leukemia can be either acute or chronic. Chronic leukemia progresses more slowly than acute leukemia, which requires immediate treatment. Leukemia is also classified as lymphocytic or myelogenous. Lymphocytic leukemia refers to abnormal cell growth in the marrow cells that become lymphocytes, a type of white blood cell that plays a role in the immune system. In myelogenous leukemia, abnormal cell growth occurs in the marrow cells that mature into red blood cells, white blood cells, and platelets. There are four broad classifications of leukemia:

  • Acute lymphocytic leukemia (ALL)
  • Acute myelogenous leukemia (AML)
  • Chronic lymphocytic leukemia (CLL)
  • Chronic myelogenous leukemia (CML)

Leukemia occurs in both adults and children. ALL is the most common form of childhood leukemia, and AML is the second most common. Decades of research have led to vastly improved outcomes for children diagnosed with ALL. The two most common adult leukemias are AML and CLL.

Am I at Risk?

Although experts are uncertain about the causes of leukemia, they have identified several risk factors that include the following:

  • Exposure to high levels of radiation
  • Repeated exposure to certain chemicals (for example, benzene)
  • Chemotherapy
  • Down Syndrome
  • A strong family history of leukemia
  • Symptoms vary depending on the type and stage of leukemia, but they can include the following:
  • Fever, chills, night sweats and other flu-like symptoms
  • Weakness and fatigue
  • Swollen or bleeding gums
  • Headaches
  • Enlarged liver and spleen
  • Swollen tonsils
  • Bone pain
  • Paleness
  • Pinhead-size red spots on the skin
  • Weight loss

How Is Leukemia Treated?

Your doctor will conduct a complete blood count (CBC) to determine if you have leukemia. This test will reveal if you have leukemic cells, or abnormal levels of white blood cells; both are signs of leukemia. Abnormally low red blood cell or platelet counts can also indicate leukemia. If you test positive for leukemia, your doctor will perform a biopsy of your bone marrow to determine which type you have.

Treatment depends on your age, general health, and type of leukemia. You might receive a combination of treatments that could include chemotherapy, biological therapy, radiation therapy, and stem cell transplantation. Patients with acute leukemia often undergo chemotherapy because this type of treatment targets fast-dividing cells. Many acute leukemia patients have responded successfully to treatment. On the other hand, because the cells divide more slowly in chronic leukemia, it is better treated with targeted therapies that attack slowly dividing cells as opposed to traditional chemotherapy that targets rapidly dividing cells.

For some patients, participating in a clinical trial provides access to experimental therapies. If you are diagnosed with leukemia, talk with your doctor about whether joining a clinical trial is right for you.

Is Leukemia Preventable?

Because the cause of leukemia remains unknown, there is no certain way to prevent it. However, avoiding exposure to solvents, such as benzene and toluene, and unnecessary exposure to x-rays is generally good practice. If you think you may be exhibiting signs of leukemia, being aware of the risk factors and symptoms and talking with your doctor are critical to early diagnosis and treatment. It is especially important for people who have a family history of leukemia to be aware of symptoms and share their family medical history with their doctors.

Lymphoma

About half of the blood cancers that occur each year are lymphomas, or cancers of the lymphatic system. This system – composed of lymph nodes in your neck, armpits, groin, chest, and abdomen – removes excess fluids from your body and produces immune cells. Abnormal lymphocytes, a type of white blood cell that fights infection, become lymphoma cells, which multiply and collect in your lymph nodes. Over time, these cancerous cells impair your immune system.

Lymphomas are divided into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma. About 12 percent of people with lymphoma have Hodgkin lymphoma. Because of breakthrough research, this once fatal diagnosis has been transformed into a curable condition. Most non-Hodgkin lymphomas are B-cell lymphomas, and either grow quickly (high-grade) or slowly (low-grade). There are 14 types of B-cell non-Hodgkin lymphomas. The rest are T-cell lymphomas, named after a different cancerous white blood cell, or lymphocyte.

Many lymphoma patients are able to lead active lives as they receive treatment for their symptoms and are monitored by their doctors.

Am I at Risk?

The exact causes of lymphoma remain unknown; however, the following factors increase your risk of developing the disease:

  • Older age
  • Male
  • Caucasian
  • Having an autoimmune disease
  • HIV/AIDS
  • Diet high in meats and fat
  • Being exposed to certain pesticides

Symptoms of lymphoma include the following:

  • Swollen lymph nodes in the neck, armpits, or groin
  • Fever
  • Weakness and fatigue
  • Weight loss
  • Sweating
  • Difficulty breathing or chest pain
  • Itchy skin
  • Rash

How is Lymphoma Treated?

Your doctor will perform a lymph node biopsy to diagnose lymphoma. Additional tests are then conducted to determine the stage (extent) of the lymphoma including blood tests, bone marrow biopsies, and imaging tests, such as a CT scan or PET scan. Imaging tests show whether the lymphoma has spread to other parts of your body, like the spleen and lungs. Decisions about treatment are then determined by your doctor, who will consider your age, general health, and stage and type of lymphoma. Hodgkin lymphoma is one of the most curable types of cancer.

Treatment options include the following:

  • Chemotherapy
  • Chemotherapy and radiation that directly targets the lymphoma
  • Biological therapies, such as antibodies, directed at lymphoma cells
  • Stem cell transplant

For some patients, participating in a clinical trial provides access to experimental therapies. If you are diagnosed with lymphoma, talk with your doctor about whether joining a clinical trial is right for you.

Is Lymphoma Preventable?

Because the cause of lymphoma remains unknown, there is no real way to prevent it. However, if you think you may be exhibiting signs of lymphoma, being aware of the risk factors and symptoms and talking with your doctor are critical to early diagnosis and treatment. It is especially important if you have a family history of lymphoma to look out for symptoms and share your family medical history with your doctor.

If you suspect that you have or are at risk for lymphoma, talk with your doctor about detection and treatment. Depending on your physical condition, genetics, and medical history, you may be referred to a hematologist, a doctor who specializes in blood conditions.

Myeloma

Myeloma is cancer of the plasma cells. Plasma cells are white blood cells that produce disease- and infection-fighting antibodies in your body. Myeloma cells prevent the normal production of antibodies, leaving your body’s immune system weakened and susceptible to infection. The multiplication of myeloma cells also interferes with the normal production and function of red and white blood cells. An abnormally high amount of these dysfunctional antibodies in the bloodstream can cause kidney damage. Additionally, the myeloma cells commonly produce substances that cause bone destruction, leading to bone pain and/or fractures.

Myeloma cells are produced in the bone marrow, the soft tissue inside your bones. Sometimes myeloma cells will travel through your blood stream and collect in other bones in your body. Because myeloma frequently occurs at many sites in the bone marrow, it is often referred to as multiple myeloma.

Am I at Risk?

Signs and symptoms of myeloma include the following:

  • Hypercalcemia (excessive calcium in the blood)
  • Anemia (shortage or reduced function of red blood cells)
  • Renal damage (kidney failure)
  • Susceptibility to infection
  • Osteoporosis, bone pain, bone swelling or fracture
  • High protein levels in the blood and/or urine
  • Weight loss

Myeloma occurs more frequently in the following populations:

  • African-American
  • Over the age of 50
  • Male
  • Obese
  • Exposed to radiation
  • Work in petroleum-related industries

How Is Myeloma Treated?

If you have myeloma, there are many treatment options available that slow the growth of the myeloma cells and help ease bone pain, fatigue, and other symptoms associated with the disease. The type of treatment depends on your health and the type and stage of myeloma.

Treatment options for myeloma include the following:

  • Chemotherapy
  • Immunomodulators (drugs that target specific areas of the immune system)
  • Anemia drugs
  • Radiation therapy
  • Stem cell transplant

For some patients, participating in a clinical trial provides access to experimental therapies. If you are diagnosed with myeloma, talk with your doctor about whether joining a clinical trial is right for you.

Is Myeloma Preventable?

Because doctors have yet to pinpoint what causes myeloma, there is no certain way to prevent it. Be aware of the risks and symptoms, especially if you have a family history of myeloma.

If you are experiencing symptoms or are at risk for myeloma, talk with your doctor about detection and treatment. Depending on your physical condition, genetics, and medical history, you may be referred to a hematologist, a doctor who specializes in blood conditions.

 

Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few other resources that may be of some help:

Articles From Hematology, the ASH Education Program Book

The American Society of Hematology (ASH) Education Book, updated yearly by experts in the field, is a collection of articles about the current treatment options available to patients. The articles are categorized here by disease type. If you are interested in learning more about a particular blood disease, we encourage you to share and discuss these articles with your doctor.

Results of Clinical Studies Published in Blood

Search Blood, the official journal of ASH, for the results of the latest blood research. While recent articles generally require a subscriber login, patients interested in viewing an access-controlled article in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.