Leukemia, Lymphoma And Multiple Myeloma

Leukemia, lymphoma, and multiple myeloma are often called “blood cancers” since they originate in blood cells, but they are distinctive from one another.

• Leukemia is a cancer of the blood and bone marrow that most often begins in white blood cells.
• Lymphoma is a cancer of the blood that originates in lymphocytes. These building blocks of the lymphatic system play a central role in the body’s immune system.
• Multiple Myeloma is a type of cancer that begins in plasma cells within the bone marrow.

Distinguishing Between Leukemia, Lymphoma and Multiple Myeloma

Within these three blood cancers, broad classes of blood cancer are multiple, distinct cancer types. 

Leukemias are cancers of the white blood cells in the bone marrow and blood and, rarely, the lymphatic system. The abnormal production of white blood cells can interfere with the body's ability to fight infections.

• Acute leukemias are faster growing than chronic ones.  There are several types of leukemia, including acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).
• Chronic myelomonocytic leukemia (CMML) and Myelodysplastic syndrome (MDS) are closely related to acute leukemia in terms of prognosis and clinical behavior.
• Chronic leukemias have a prolonged clinical course-chronic myeloid leukemia (CML), Polycythemia vera (PV) and Essential Thrombocythemia (ET) and primary myelofibrosis (PMF) belong to this category.

• Lymphomas are cancers of immune cells called lymphocytes. Lymphomas are typically diagnosed as either indolent (slow-growing) or aggressive, and can be found in various parts of the body, including the lymph nodes, spleen and bone marrow.. More than 70 different types of lymphomas exist – and each is identified broadly as either non-Hodgkin lymphoma or a Hodgkin lymphoma, depending on the type of lymphocyte being affected. Diffuse large b-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, while classical nodular sclerosis type is the most commonly diagnosed Hodgkin lymphoma.

Myeloma, also known as multiple myeloma, is a cancer of the plasma cells, immune cells that are found in the bone marrow. When myeloma cells multiply, this can lead to bone damage, anemia, kidney problems, high blood calcium levels and a weakened immune system. Myeloma is usually diagnosed as either active or indolent – sometimes also referred to as “smoldering myeloma” – meaning it does not currently cause outward symptoms.

How Common Are Blood Cancers?

Blood cancers are far more common than you might think: One person in the United States is diagnosed with a blood cancer, including leukemia, lymphoma or myeloma, every three minutes. The American Cancer Society estimates that in 2025:

• 66,890 Americans will be diagnosed with leukemia, including 1,330 in Indiana and 2,430 in Illinois
• 89,070 Americans will be diagnosed with non-Hodgkin lymphoma, including 1,600 in Indiana and 3,090 in Illinois

Who Is At Risk For Blood Cancers?

In general, the risk of developing leukemia, lymphoma, or multiple myeloma increases with age. The majority of diagnosed blood cancers occur in patients over the age of 60. Smoking also increases the risk of developing these cancers. People with a family history of these conditions may also be more likely to develop the disease themselves. Other risk factors include prolonged exposure to radiation or certain chemicals or the presence of an autoimmune disease or other conditions that could lead to a weakened immune system.

Symptoms Of A Blood Disorder

The outward symptoms of leukemia, lymphoma and multiple myeloma are similar and include:

• Excessive or unusual bleeding
• Fatigue
• Frequent infections
• Persistent Fever
• Shortness of breath
• Unusual swelling of the lymph nodes
• Weight loss

Meanwhile, in addition to the above symptoms, patients with myeloma also frequently report noticing persistent bone pain, particularly in the back or hips.

Diagnosis Of A Blood Disorder

Typically, a diagnosis for leukemia, lymphoma or multiple myeloma begins with a simple blood test known as a complete blood count (CBC). This test provides information about the levels of red blood cells, white blood cells, and platelets in the bloodstream. If results show an abnormal level of any of these cells, imaging tests plus either a bone marrow biopsy or lymph node biopsy may be ordered to provide a diagnosis.

The Latest Blood Cancer Treatments Available

If one of these blood cancers is diagnosed, patients are referred to an oncologist (a cancer specialist) and a hematologist (a physician specializing in treating diseases of the blood). Treatment plans are customized to each individual.

“Treatment typically involves chemotherapy in combination with targeted immunotherapy,” said Felix Mensah, MD, an oncologist with Franciscan Health Indianapolis.

Immunotherapy – sometimes called immuno-oncology – refers to the use of drugs or other interventions that work to empower the body’s own immune system to more successfully target and attack cancer.

“As part of treatment, some patients may also need a bone marrow transplant, stem cell transplantation, or other novel therapies, such as CAR T-cell therapy,” Dr. Mensah said.

In CAR T-cell therapy, a patient’s T-cells – a type of immune cells found in the blood – are collected and reengineered in a lab. They are then reintroduced into the body and work to attack the cancer cells.

Most patients undergo a targeted combination of chemotherapy and immunotherapy for three to six months – a process that’s made easier with the compassionate team at Franciscan Health.

“We offer the latest, cutting-edge treatments available today, and our entire care team is made up of supportive, compassionate team members,” said Dr. Mensah. “The quality of care that is available at Indiana Blood & Marrow Transplantation (IBMT) – Franciscan Health’s specialized, Indianapolis-based center for treatment of leukemia, lymphoma and myeloma – is on par, I believe, with any top institution in the country.”

HealthDay News contributed information to this article.