In this Article

What are Blood Cancers?

Blood cancers are cancers of the blood, bone marrow (which makes blood cells), and lymph system (an important part of your immune system). The most common blood cancers are leukemia and lymphoma. A less common blood cancer is Multiple myeloma.

The body has three types of blood cells that are made by stem cells in the bone marrow:

  • Red blood cells carry oxygen to the body.
  • White blood cells fight infection.
  • Platelets form clots to slow or stop bleeding.

Cancers of the blood and lymph make it difficult for each of these blood cells to do its work.

What is Leukemia?

Normal blood cells die when they no longer work, but cancerous white blood cells don’t die and they make copies of themselves. In a person with leukemia, the blood stem cells make abnormal white blood cells that don’t work properly. Normal blood cells die when they no longer work, but cancerous white blood cells don’t die and they make copies of themselves. Soon, the abnormal white blood cells are crowding out the healthy blood cells.

Once there are a lot of these abnormal cells taking the place of the healthy ones, the person’s blood can’t do what it is supposed to do. The person can’t get enough oxygen to the body, fight infections, or clot blood to stop bleeding.

Leukemia cells can either grow slowly and cause problems over time (chronic) or grow quickly and cause an immediate and sudden problem (acute).

There are four main types of leukemia:

  • Acute lymphoblastic (lymphocytic) leukemia – ALL
  • Acute myeloid (myelogenous) leukemia – AML
  • Chronic lymphocytic leukemia- CLL
  • Chronic myeloid (myelogenous) leukemia- CML

All different types of leukemia will have different treatments. The one thing they have in common is they begin in a cell in the bone marrow. The cell will undergo a change and become a type of leukemia cell.

Symptoms

Some signs and symptoms of leukemia are similar to common illnesses so specific blood tests and procedures are needed to make a diagnosis.

Signs and symptoms may vary but they may include:

  • Fatigue
  • Shortness of breath with activity
  • Pale appearing skin
  • Mild fever or night sweats
  • Excessive bruising and bleeding
  • Slow wound healing
  • Bone or joint pain
  • Abnormal blood counts
  • Frequent infections
  • Enlarged lymph nodes

Chronic leukemia’s may not have symptoms and patients may find out they have cancer after a routine blood test at their doctor’s office. These are slow growing cancers and wouldn’t prompt a patient to be seen by a physician as they don’t always manifest symptoms.

Diagnosis and Tests

Your doctor may do these tests to find out if you have a blood cancer:

  • Complete blood count (CBC) test - This blood test may show high or low levels of white blood cells (infection fighters). Sometimes red blood cells (carry oxygen to the body) and platelet (forms clots) counts are low.
  • Bone marrow aspiration - a liquid sample of cells taken from the bone marrow. This is done by a needle. The sample is most often collected from a patient’s hip bone.
  • Bone marrow biopsy - A small amount of bone filled with marrow cells is removed by the same procedure with a needle. Marrow is the cell factory making portion of your bones.
The samples are reviewed and tested under a microscope to identify the chromosome abnormalities. This identifies the type of leukemia, so your physician can determine which treatment options are right for you.

Treatments

Treatment is determined by the type of Leukemia. If it is chronic it can, in some instances, be in a period called “watch and wait.” This means that no treatment is advised at that time but is monitored to see if it progresses in which treatment would be advised. Acute Leukemias require treatment and may include targeted therapy, chemotherapy and/or stem cell transplants.

  • Targeted therapy - Medication that targets and kills specific cancer cells. It does not cause as many side effects as chemotherapy.
  • Chemotherapy - Medication that kills or damages cancer cells and can sometimes affect healthy cells. It has an array of potential side effects that your provider will discuss with you how to manage symptoms. The goal of therapy is to bring a patient into remission where there are no signs of the disease and the patient can return to good health.
  • Stem cell transplant - A procedure that replaces healthy cells to a person whose cells have been abnormal and defective. This is quite a process to get a patient ready for transplant and requires chemotherapy prior to, a lot of additional work up procedures and planning on which type of transplant is appropriate. Some transplants are to replace healthy cells only and other transplants are used to help fight the cancer. Ask your physician if you are eligible for a transplant. The goal of this treatment is to bring a patient into a complete remission.

Prognosis

Many things can affect a patient’s prognosis which would include:

  • Stage of disease and when treatment was started
  • Age and health status of the patient
  • Adherence to treatment
  • Good self-care to manage potential side effects

Discuss the prognosis of your cancer and it’s treatment course with your oncologist.