Cancer Type
Blood cancer
Most blood cancers, also called hematologic cancers, start in the bone marrow, which is where blood is produced. Blood cancers occur when abnormal blood cells start growing out of control, interrupting the function of normal blood cells, which fight off infection and produce new blood cells.
Types of blood cancer
The three main types of blood and bone marrow cancer are leukemia, lymphoma, and myeloma:
- Leukemia is a blood cancer that originates in the blood and bone marrow. It occurs when the body creates too many abnormal white blood cells and interferes with the bone marrow’s ability to make red blood cells and platelets.
- Non-Hodgkin lymphoma is a blood cancer that develops in the lymphatic system from cells called lymphocytes, a type of white blood cell that helps the body fight infections.
- Hodgkin lymphoma is a blood cancer that develops in the lymphatic system from cells called lymphocytes. Hodgkin lymphoma is characterized by the presence of an abnormal lymphocyte called the Reed-Sternberg cell.
- Multiple myeloma is a blood cancer that begins in the blood’s plasma cells, a type of white blood cell made in the bone marrow. Also, learn about the stages of multiple myeloma.
Risk Factor.
- Exposure to cancer-causing agents. People exposed to high doses of radiation (from the explosion of an atomic bomb, working in an atomic weapons plant, or a nuclear reactor accident) have a heightened risk of developing leukemia. Long-term exposure to high levels of solvents such as benzene — in the workplace, for example — is a known risk factor. CLL may also be linked to exposure to Agent Orange, a chemical used widely during the Vietnam War.
- Smoking. Cigarettes contain dozens of cancer-causing chemicals. Researchers estimate that about 20 percent of AML cases are related to smoking.
- History of radiation therapy or chemotherapy. Radiation therapy and chemotherapy can cause mutations, or changes in a cell’s DNA, that later may lead to cancers including leukemia. AML is linked to treatments for Hodgkin’s disease, non-Hodgkin lymphoma, childhood ALL, and other malignancies such as breast cancer, and ovarian cancer.
- Myelodysplastic syndromes. About one-third of patients who have this bone marrow failure disorder may eventually develop leukemia.
- Rare genetic syndromes. People with Down syndrome, Fanconi anemia, ataxia-telangiectasia, and Bloom syndrome are at slightly higher risk for developing leukemia.
- Family history. People who have a first-degree relative — a parent, child, or sibling — with CLL have a two- to four-fold increased risk of developing CLL. Most people who develop leukemia, however, do not have a relative with the disease.
Symptoms.
Some common bone marrow and blood cancer symptoms include:
- Fever, chills
- Persistent fatigue, weakness
- Loss of appetite, nausea
- Unexplained weight loss
- Night sweats
- Bone/joint pain
- Abdominal discomfort
- Headaches
- Shortness of breath
- Frequent infections
- Itchy skin or skin rash
- Swollen lymph nodes in the neck, underarms, or groin
Diagnosis.
Determining a diagnosis often starts with a physical examination to check your general health. Your doctor will review your health history, examine your body and lymph nodes, and look for any signs of infection or bruising.
Different types of tests and procedures may be used to diagnose blood cancer. What you need will depend on the type of blood cancer suspected. Your care team may recommend testing and evaluating all the results along with you to make a diagnosis.
Biopsies
A biopsy is a test that collects samples of cells for examination by a pathologist in a laboratory. For some types of blood cancer, like lymphoma, you may need a lymph node biopsy that obtains a sample of lymph tissue or an entire lymph node.
Testing your bone marrow, where blood cells are formed, can help diagnose certain types of blood cancer. Doctors use a procedure called a bone marrow aspiration to remove a small sample of bone marrow, blood and bone from either a hip bone or breastbone. The sample is sent to a lab and checked for abnormal cells or changes in genetic material.
Imaging scans
Imaging scans are more helpful for some types of blood cancer than others. A scan may spot an enlarged lymph node, which is a common symptom of lymphoma, but it’s not usually used to diagnose leukemia, a blood cancer that doesn’t cause visible tumors. Still, scans may help whether cancer has affected other parts of the body.
Scans include:
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan
- X-ray
- Ultrasound
Certain types of scans are used during biopsies to help pinpoint the area to be sampled.
Blood tests
A complete blood count (CBC). shows the cell count of different components of blood, such as white blood cells, red blood cells, and platelets.
Blood chemistry tests measure levels of key substances in your blood. Abnormal levels of certain proteins, for example, may offer information about your condition. If multiple myeloma is suspected, doctors may want to check your blood calcium level. For possible lymphoma, an enzyme called lactate dehydrogenase (LDH) may be measured.
Treatment.
Treatment for blood and bone marrow cancers depends on the type of cancer, your age, how fast the cancer is progressing, where the cancer has spread, and other factors. Some common blood cancer treatments for leukemia, lymphoma, and multiple myeloma include:
Stem cell transplantation: A stem cell transplant infuses healthy blood-forming stem cells into the body. Stem cells may be collected from the bone marrow, circulating blood, and umbilical cord blood.
Chemotherapy: Chemotherapy uses anticancer drugs to interfere with and stop the growth of cancer cells in the body. Chemotherapy for blood cancer sometimes involves giving several drugs together in a set regimen. This treatment may also be given before a stem cell transplant.
Radiation therapy: Radiation therapy may be used to destroy cancer cells or to relieve pain or discomfort. It may also be given before a stem cell transplant.