What are bone marrow and blood cancers?

Healthy blood cells include a balance of different cell types.

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.

This article will cover:

• Types of blood cancer
• Blood cancer symptoms
• Causes of blood cancer
• How is blood cancer diagnosed?
• Blood cancer treatment and therapy options
• Blood cancer survivor rates

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.

There are also less common forms of blood and bone marrow cancers, or associated disorders, including:

• Myelodysplastic syndromes (MDS): These are rare conditions that may result from damage to blood-forming cells in the bone marrow.
• Myeloproliferative neoplasms (MPNs): These rare blood cancers occur when the body overproduces white blood cells, red blood cells or platelets. The three main subcategories are essential thrombocythemia (ET), myelofibrosis (MF) and polycythemia vera (PV).
• Amyloidosis: This rare disorder, characterized by the buildup of an abnormal protein called amyloid, is not a form of cancer. But it is closely associated with multiple myeloma.
• Waldenstrom macroglobulinemia: This is a rare type of non-Hodgkin lymphoma that starts in B cells.
• Aplastic anemia: This rare condition occurs when key stem cells are damaged and can only be treated with a bone marrow transplant.

Blood cancer 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

Causes of blood cancer

All blood cancers are caused by mutations in the genetic material—the DNA—of blood cells. Other risk factors vary based on the specific type of blood cancer.

Risk factors for developing acute myeloid leukemia (AML), the most common form of leukemia in adults, include:

• Advancing age
• Gender: being male
• Exposure to industrial chemicals such as benzene
• Smoking
• History of cancer treatment
• Exposure to high doses of radiation
• History of other blood cancers

Risk factors for developing Hodgkin lymphoma include:

• History of infection with Epstein-Barr virus (EBV), which causes infectious mononucleosis (mono)
• Advancing age
• Gender: Being male
• Family history of Hodgkin lymphoma
• Compromised immune system

Risk factors for developing non-Hodgkin lymphoma include:

• Exposure to certain industrial chemicals, herbicides and insecticides
• History of chemotherapy
• Radiation exposure
• Compromised immune system
• History of autoimmune diseases such as rheumatoid arthritis or lupus

Risk factors for developing multiple myeloma include:

• Advancing age
• Gender: Being male
• Race: Higher risk among African-Americans
• Obesity or extra body weight

How is blood cancer diagnosed?

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 evaluate 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.

Blood cancer treatment and therapy options

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.