BLOOD CANCER: TYPES AND TREATMENT

Dr Mitu Shrikhande

Director- Hematology 

Fortis Cancer Institute- Vasant Kunj

Blood is a vital organ and is the main transport system in the body. It carries oxygen and nutrients to the various tissues and carries away toxins and waste products to our kidneys only to be removed away from the body. Plasma is its liquid component in which the blood cells including Red blood cells (RBCs), White blood cells (WBCs) and Platelets are suspended. Blood cells develop from Stem cells in a spongy tissue inside the bones known as Bone marrow. Blood cancers arise from blood cells, bone marrow or the lymphatic system. These can affect anyone regardless of race, age or gender. The three main types of blood cancers include Leukemia, Lymphoma and Myeloma.

LEUKEMIA

Leukemia originates from bone marrow cells. Due to the proliferative and survival advantage of the cancer cells, the leukemic cells outgrow the normal blood cells in numbers resulting in decreased number and function of the normal cells. This results in symptoms of anemia, increased susceptibility to infections and bleeding. Leukemia can be divided based on- How fast they develop (Acute or Chronic) and Cell of origin (Lymphoid or Myeloid).

LYMPHOMA

Lymphomas originate in the lymphatic system. There are broadly of 2 types i.e. Non-Hodgkin’s Lymphoma & Hodgkin’s Lymphoma. Symptoms may include painless lumps in the armpit, neck and groin with or without unexplained persistent fever, weight loss and night sweats. There are two types of Lymphoma - Non-Hodgkin’s Lymphoma & Hodgkin’s Lymphoma

MYELOMA

It is a cancer arising from the plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system. Plasma cells make the antibodies, also called as Immunoglobulins that help the body attack and kill the infectious organisms. Patient’s may be asymptomatic or may have non-specific symptoms like bone pain, loss of appetite, constipation, kidney dysfunction, infections, fever or weight loss.

TREATMENT OPTIONS IN BLOOD CANCER: DIAGNOSIS OF BLOOD CANCER IS NOT A DEATH SENTENCE.

1. Accurate diagnosis is imperative prior to formulating a treatment plan. Treatment may vary with diagnosis and may include the following modalities alone, sequentially or in combination.
2. Active surveillance- It’s generally advocated that we need to detect and treat cancers in their early stages to improve outcomes. 
3. Best supportive care including transfusions of blood components are an integral part of the definitive treatment protocols of all blood cancers.
4. Chemotherapy means administration of chemicals or drugs to cause cell death. 
5. Radiation therapy it is used for conditioning before transplant in myeloma & lymphoma 
6. Stem cell transplant 
7. Targeted therapy 
8. Immunotherapy
9. Cellular therapy or CAR-T therapy 
10. Surgery rarely has any therapeutic role in the treatment of blood cancers. Procedures like lymph node biopsy are purely for diagnostic purposes.