Blood Cancer: Types, Causes and Treatment

What are blood cancers?

Blood cancers are the cancers arising from blood cells, they affect the production and function of normal blood cells namely red blood cells, white blood cells, and platelets.

Blood cancers differ from other cancers arising from solid organs in their origin, symptomatology, diagnosis and treatment.

What are the common types of blood cancers?

Following are the common types of blood cancers:

1. Hodgkin And Non-Hodgkin Lymphoma

2. Acute Leukemia

3. Multiple Myeloma

4. Chronic Leukemia

5. Myeloproliferative Neoplasms

6. Myelodysplastic syndrome

7. Other Rare Types Of Blood Cancers 

What are the common clinical manifestations of blood cancers?

Blood cancer patients may present with varied clinical manifestations, following are some of the common symptoms of blood cancer:

1. Generalized Weakness, Fatigue, and Malaise

2. Bleeding manifestations like easy bruising, Bleeding gums

3. Unexplained loss of appetite and Weight loss

4. Sweating of the body during the night

5. Swellings in the neck, armpit,  or other areas due to Lymph node (gland) enlargement

6. Lumps or underlying abdominal disease due to enlarged abdominal organs

7. Shortness of breath

8. Minimal body strain results in bone fractures called a pathological fracture

If any of the above symptoms are observed such individuals should seek medical advice and undergo evaluation

What are the common tests performed to diagnose blood cancers?

Following tests may be required to diagnose blood cancers: 

1. Initially, doctors take history and conduct a thorough physical examination of the patient

2. Blood tests looking at various blood elements called complete blood count with peripheral smear, biochemical evaluations of liver and kidney function tests are initially performed

3. Many times a special test termed bone marrow examination is done to diagnose blood cancers. It is a simple outpatient test where bone marrow samples are obtained by marrow aspiration and biopsy. Bone marrow is soft, gelatinous tissue that fills the medullary cavities, it contains stem cells that are mother cells forming all formed elements of the blood.

4. Lymph node or tissue biopsy- Surgical lymph node removal termed excision biopsy, or core biopsies collecting small pieces of the lymph node may be done to establish the diagnosis of the blood cancer 

5. Diagnostic imaging tests like CT scan, PET scan, MRI, and/or  x-rays may be performed to assess the extent of the disease at diagnosis, termed pre-treatment staging and later for assessing response after treatment. All the tests are available at Manipal, the top cancer hospital in India. 

What are Blood cancer treatment options?

Treatment for blood cancer depends on many host factors like age of the patient, comorbid illnesses, fitness level, disease-related factors such as type of blood cancer, the aggressiveness of cancer, and its stage at diagnosis. You should consult with the best oncologist in India for effective treatment.

Some common blood cancer treatments include:

Chemotherapy: Chemotherapy uses anticancer drugs to stop the growth of cancer cells in the body. Chemotherapy for blood cancer sometimes requires several drugs together in a set regimen. This treatment may also be given before a stem cell transplantation called conditioning chemotherapy.

Blood and Bone marrow transplantation: Haematopoietic stem cell transplantation is one of the intense medical therapies offered for blood cancer patients.  The patient is given conditioning therapy followed by an infusion of healthy blood-forming stem cells. Stem cells may be collected from the bone marrow, circulating blood or umbilical cord blood

Following are the common types of bone marrow transplantation:

Autologous Bone Marrow Transplant-transplanted stem cells collected from the patient.

Allogeneic Bone Marrow Transplant-transplanted stem cells are collected from a healthy donor.

Depending on the donor allogeneic transplants are divided into the following subtypes:

1. Matched Related Donor Transplant

2. Matched Unrelated Donor Transplant

3. Half-Matched Family Member Donor Transplant

4. Cord Blood Transplants

Immunotherapy: Immunotherapy sometimes also referred to as biotherapy - uses one’s own immune system to help fight cancer.

It can work directly with the body's immune system to stop or slow the growth of cancer cells. Or, it can indirectly prepare the immune system to destroy or attack cancer cells.

CAR-T Therapy

CAR T cell therapy is a type of immunotherapy, here patient’s own T cells – a type of disease-fighting immune cells – are removed and sent to a lab where they are genetically re-engineered to produce chimeric antigen receptors (CARs) on their surface, which can recognize, attack and destroy the cancer cells. 

Radiation Therapy 

Radiation therapy may sometimes be used with systemic therapy in treating blood cancers, it may be used to destroy cancer cells or to relieve pain or discomfort. It may also be given before a stem cell transplantation as part of conditioning therapy. Radiation therapy uses targeted energy to destroy cancer cells or shrink tumours.

What are common Chemotherapy related adverse effects?

Different chemotherapy has different side effects.

Fatigue, Nausea, Vomiting, lowering of the blood counts, and hair loss are few of the common adverse effects. Rarely intense chemotherapy may have adverse effects on other organ systems like the heart lungs, reproductive organs

Cancer care teams will not only take measures to minimize the adverse events but also address any side effects as they appear during or post-therapy. 

Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation

Dr. Mallikarjun Kalashetty

Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation

Old Airport Road - Bengaluru