Blood cancers are cancers of the blood cells. They occur due to mutations or genetic changes in the DNA of stem cells or blood forming precursors in the bone marrow resulting in uncontrolled proliferation of blood cells. Acute and chronic Leukemias, lymphomas and plasma cell disorders are the different types of blood cancers seen in adults.
Acute leukemia- This is a rapidly progressive type of blood cancer which needs urgent evaluation and treatment. There is excessive production of cancer cells called blasts in the bone marrow which leaves no room for development of healthy blood cells. This results in symptoms of anemia, bleeding due to low platelet counts and fever. White blood counts can be very high or low. Diagnosis is usually established by a bone marrow examination with special tests done to identify the type of acute leukemia i.e whether it is acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Treatment comprises of intravenous chemotherapy, supportive care with antibiotics to control infection and blood and platelet transfusions. For some high risk cases bone marrow transplantation is curative.
Multiple Myeloma- This is a cancer of plasma cells, a type of blood cells involved in antibody production. In patients affected with myeloma, these plasma cells become abnormal and produce a toxic protein called the M protein or monoclonal protein which damages various organs of the body including bones and kidney. Common symptoms include anemia, bone pains and pathological fractures, renal failure and high calcium levels. Treatment is with chemotherapy and immune-modulating drugs. Young and fit individuals are also offered autologous stem cell transplant for long term disease control.
Lymphomas- Lymphomas also arise from the white blood cells or lymphocytes. They present with painless enlargement of lymph nodes, liver and spleen along with symptoms of fever, weight loss, drenching night sweats and fatigue. Diagnosis usually requires a lymph node biopsy. Staging requires a whole body pet-CT and bone marrow examination. Lymphomas can be classified as Hodgkin’s Lymphoma and Non-Hodgkin’s lymphoma. Treatment for lymphomas is with chemotherapy, immunotherapy and radiation. Bone marrow transplant is usually reserved for high risk cases
Chronic Myeloid Leukemia (CML)- This blood cancer usually has an indolent course with gradual appearance of symptoms. Symptoms include fatigue, loss of appetite and awareness of an abdominal mass due to an enlarged spleen. Blood tests reveal a markedly elevated white blood cell count. Therapy for CML is very effective and involves targeted treatment with oral drugs.
Chronic Lymphocytic Leukemia(CLL) - The other common chronic leukemia is Chronic Lymphocytic leukemia which is a slow growing cancer that develops when bone marrow starts producing excessive B lymphocytes, a type of white blood cell. Patient may be completely asymptomatic initially or can have lymphoma like symptoms. Diagnosis is established through sophisticated blood investigations and molecular tests. Again the treatment is very effective with oral and intravenous chemo-immunotherapy.
