Identifying Types and Treatment Options. Why is it important?

Every three minutes, someone in the U.S. is diagnosed with a blood cancer. More than 1.3 million Americans are living with or in remission from a blood cancer. Even though there are fewer than 200,000 blood cancers cases per year, they are the third leading cause of cancer deaths in the United States. In 2010, Congress designated September as National Month to promote awareness, support and research on blood cancers. Feist-Weiller Cancer Center at LSU Health Shreveport recently celebrated the 1st Annual Blood Cancer Awareness Day on Sept.Blood cancers affect the different blood cells (white blood cells, red blood cells, platelets) in the blood, bone marrow and the lymphatic systems. While no effective screening exists, knowing the general signs, symptoms and risk factors can help understand when to seek medical attention.

Signs and symptoms:

Most blood cancers often start in and affect the bone marrow, where blood cells are produced. In leukemia, cancerous cells are usually found in the blood and bone marrow, while in lymphoma, the cells tend to aggregate and form masses, or tumors, in lymphatic tissues. Some patients with chronic leukemia are asymptomatic.

When cancerous blood cells grow out of control, the production and function of normal blood cells are affected adversely, which cause the associated signs and symptoms:

• Low red cells (Anemia): Fatigue, pallor, shortness of breath, dizziness

• Low white blood cells (Leucopenia):

Compromised immune system, repeated infections

• Low platelets (Thrombocytopenia): Bleeding or bruising easily

• General symptoms: Weight loss, fever, poor appetite, night sweats, unexplained weight loss

• Swelling in the lymph nodes (e.g., lumps in the neck, underarm or groin) or abdomen

Risk factors:

• Age: most cancers increase with age

• Cigarette smoking

• Ionizing radiation exposure

• Chemical exposures (e.g., benzene, some chemotherapy)

• Genetic abnormalities

• Severely altered immune function

• Infections (e.g., Epstein-Barr virus, Human Immune Deficiency Virus, Hepatitis C)

Three main types of blood cancers:

Leukemia is a cancer of the bone marrow and blood. There are four main groups based on the involved cell type and how fast the cancer cells are growing: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). Many patients with slow-growing types of leukemia don’t have symptoms. Signs and symptoms of leukemia can appear suddenly for acute subtypes. Treatment is variable. For slowgrowing leukemias, treatment may include monitoring to chemo-immunotherapy. Treatment includes chemotherapy with or without targeted therapy drugs, radiation and stem cell transplant for aggressive leukemias.

Lymphoma is a cancer of the lymphatic system, which is the part of the immune system that protects the body from pathogens, maintains body fluid levels, absorbs fats in the digestive tract and removes cellular waste. The main types of lymphoma are Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Most HL and aggressive types of NHL can often be cured. Treatment may involve chemotherapy, targeted or immunotherapy drugs, radiation and stem cell transplant. Newer therapies that help the body’s immune system recognize and attack lymphoma cells (e.g., CAR T-cell therapy) have shown promising results for some hard-to-treat lymphomas.

Myeloma or multiple myeloma is a cancer of the bone marrow involving a specific subset of white blood cells called plasma cells. Plasma cells make antibodies, proteins that protect us from infection. Treatment includes corticosteroids, targeted or immunotherapy drugs, chemotherapy, radiation or stem cell transplant.

Blood Cancer Care at Feist-Weiller Cancer Center

The hematologic malignancy (blood cancer) team at Feist-Weiller Cancer Center (FWCC) provides standard chemoimmunotherapy treatments for all types of blood cancers. Additionally, FWCC’s Leukemia/Blood and Marrow Transplant Program is the sole provider in Northwest Louisiana of intensive induction therapy for acute leukemia and autologous stem cell transplant (patient is a stem cell donor). The program is working to bring allogeneic stem cell transplant (donor is someone other than the patient) and cellular therapy services to the region in the future.

Patients have access to several clinical trials on leukemia, lymphoma and myeloma from National Cancer Institute Community Oncology Research Program (NCORP). Various investigator-initiated clinical trials are in the process of opening soon.

Ways to Observe Blood Cancer Awareness Month

1. Raise awareness

2. Donate time (e.g., voluntary ride services) or funds to organizations supporting blood cancer patients and research

3. Donate blood products

4. Volunteer at bone marrow/stem cell donor registries Data sources: American Cancer Society, Leukemia and Lymphoma Society.

Disclaimer: This article is for informational or educational purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment.

Tamna Wangjam, MD, MBBS, is an assistant professor of medicine at LSU Health Shreveport and the program director of the Leukemia/ Blood and Marrow Transplant Program at Feist-Weiller Cancer Center with Ochsner LSU Health Shreveport.