Overview

Blood-cancer is one of the more common types of cancer, accounting for nearly 5-10% of all cancer types, depending on the country surveyed. There are three main types of blood-cancer with multiple sub-types. In spite of the scare created around blood-cancer, the survival rates of people with blood-cancer are comparable to that of other cancers, provided the condition is diagnosed early, and based on certain parameters. It is important that one is aware of the symptoms and risk factors, so that one can seek timely medical help.

Introduction

The blood is an important component of the human body and is responsible for various functions. It consists of three primary components:

• Red-blood cells (RBCs): These act as carriers, transporting oxygen to the body’s cells and bringing carbon-di-oxide from the cells to the lungs from where that is exhaled out.
• White-blood-cells (WBCs): They are an important component of the immune system as they help fight infection and disease.
• Platelets: These help the blood clot when there is an injury, thereby preventing excessive blood-loss.

The blood-cells are generated in the bone-marrow, which is a spongy tissue in the centre of the bones.

Also Read: What is the function of bone marrow? How are bone marrow tests done?

What is cancer in general?

DNA present in the heart of any cell carries the code for how the cell has to grow and function, multiply or divide, and when it should decay and die. Any genetic mutation of the DNA causes this order, or this function of the DNA, to get disrupted. As a result, cells grow abnormally, and/or they do not function properly, and/or they multiply and divide randomly without reason, and/or they do not decay or die as expected.

As a result, a large number of abnormal cells develop in that tissue. This in turn disrupts the healthy functioning of the tissue. This uncontrolled growth can be slow and long-term (called a chronic cancer), or it can be quick and short-term (called acute cancer). Cancer is the name of the condition, while the abnormal clump of cells is collectively called a tumour. This is what is cancer in general.

What is blood-cancer?

When the same phenomenon happens in the blood cells, that is, when there is genetic mutation of the DNA in blood cells, the condition is called blood-cancer. One or more of these happen then: the blood cells grow abnormally in shape and size; they do not perform the blood-cells’ functions as outlined above, and they multiply in large numbers thereby crowding out healthy blood-cells. As a result, overall functioning of blood is disrupted, leading to serious consequences.

Symptoms of blood-cancer

• Chronic weakness and fatigue
• Fever and chills
• Nausea and vomiting
• Loss of appetite
• Sweating in the night
• Unexplained weight loss
• Headache
• Pain and discomfort in the abdomen
• Pain in the bones and/or joints
• Recurring infections
• Shortness of breath (dyspnoea)
• Swollen lymph nodes in the groin, neck and underarms
• Itchy skin, skin rashes and other skin conditions

Causes and Risk-factors of blood-cancer

Unlike other cancers where genes play a role, in the case of blood-cancer, the probability of inheriting blood-cancer from a parent or grand-parent is very, very low. All causes and risk factors for the condition, are environment or pathological. They are as follows, across the different types of blood-cancer:

• Age: Advancing age increases the risk
• Gender: Men are at higher risk than women
• Smoking over a long time
• Exposure to industrial chemicals such as benzene, insecticides and herbicides
• History of treatment for cancer
• Exposure to high doses of radiation, from cancer treatment or repeated scans
• Personal history of other blood-cancers
• Family history of Hodgkin lymphoma
• History of infection with Epstein-Barr virus (EBV)
• A weak or compromised immune system
• Personal history of autoimmune diseases such as lupus or rheumatoid arthritis
• Race: African-Americans are at higher risk than other races
• Obesity, or being overweight

Also Read: When do swollen lymph nodes mean cancer?

Types

Broadly, blood-cancer is of 3 types: Leukaemia, Lymphoma and Myeloma, and each of these types have multiple sub-types. From the description given below, the multiple sub-types may appear identical to a layman. However, pathologically they are different, and a qualified oncologist (cancer specialist) can identify the precise type, based on diagnostic reports and symptoms.

LEUKAEMIA

Leukaemia is a type of blood-cancer that affects blood cells in the bone-marrow, and most often the white blood cells. There are various sub-types:

• Acute myeloid leukaemia (AML): This is a rapidly developing type of leukaemia that affects myeloid blood cells.
• Acute erythroid leukaemia: This affects the RBCs and is sub-type of (AML).
• Acute lymphoblastic leukaemia (ALL): This is a rapidly developing type of leukaemia that affects cells called lymphoblasts.
• Acute megakaryoblastic leukaemia: This affects the platelets and is a sub-type of AML.
• Acute promyelocytic leukaemia (APL): This affects promyelocytes, which are premature WBCs.
• Chronic lymphocytic leukaemia (CLL): This slowly-developing condition affects a type of WBCs in the bone-marrow called lymphocytes.
• Chronic myeloid leukaemia (CML): This affects a type of WBCs called myeloid cells.
• Chronic myelomonocytic leukaemia (CMML): This affects a type of WBCs called monocytes.
• Childhood leukaemia: As the name implies, this affects children below 15 years of age.
• Hairy cell leukaemia (HCL): This affects a type of WBCs called lymphocytes.
• Large granular lymphocytic leukaemia (LGLL): This too affects lymphocytes.
• Mast cell leukaemia (MCL) and Mastocytosis: These affect the mast cells, which are part of the immune system.

LYMPHOMA

Lymphoma is a type of blood-cancer that affects white blood cells called lymphocytes, which are an important part of the immune system. Lymphocytes circulate in the body through the lymphatic system. When lymphocytes turn into lymphoma cells, they accumulate in the lymph nodes and impair the body’s ability to fight infection or disease. Sub-types are:

• Hodgkin lymphoma
• Non-Hodgkin lymphoma
• Burkitt lymphoma: A rare type of non-Hodgkin lymphoma
• Diffuse large B-cell lymphoma (DLBCL): A type of non-Hodgkin lymphoma
• Follicular lymphoma: A slowly-developing type of non-Hodgkin lymphoma (NHL)
• MALT lymphoma: This is part of a set of blood-cancers called marginal zone lymphomas.
• Mantle cell lymphoma
• Small lymphocytic lymphoma (SLL)
• Waldenström macroglobulinaemia (WM): A slowly-developing and rare form of non-Hodgkin lymphoma. This affects the plasma cells in the blood.

MYELOMA

Myeloma is a type of blood-cancer that affects a type of WBC called plasma cells. Sub-types:

• Myelodysplastic syndromes (MDS): This is a set of conditions in which the bone-marrow doesn’t function properly and produces faulty blood cells.
• Myeloproliferative neoplasms (MPN): This again has 3 sub-types:

1. Polycythaemia vera (PV): In this, the body produces too many RBCs.
2. Essential thrombocythaemia (ET): A slowly-developing condition in which the body produces too many platelets.
3. Myelofibrosis: In this condition, scar tissue starts forming in the bone-marrow

• Myelodysplastic/myeloproliferative neoplasms (MDS/MPN overlap)

MDS/MPN overlap syndromes is a set of blood-cancers that combine features of both MDS and MPN.

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