Our blood contains red and white cells, platelets, and a yellowish-clear liquid called plasma. Healthy red blood cells carry oxygen throughout the body. White blood cells fight infections (and sometimes cancer) and dispose of debris and other aging cells. The plasma and platelets help the blood clot when there's an injury.

The blood cells and platelets start as stem cells inside the bone marrow, lymph nodes, spleen, or liver. Most blood cancers begin when one of these stem cells mutates and grows too fast, making lots of abnormal blood cells.

The abnormal cells and components stop blood from working normally. When that happens, your body can’t fight off infections or work as it should.

At Carilion, our cancer experts care for many blood cancers, including the 3 most common types. When the cancer manifests as mostly abnormal cells in the blood, we use the term leukemia, and when the cells cluster in the lymph tissue, we call it lymphoma—these are more “solid.” 

Leukemia

Most leukemias start when mutated stem cells make large amounts of abnormal white blood cells. Your leukemia type depends on which white blood cells are abnormal.

Leukemia can be fast (acute) or slow (chronic) growing. We need to treat acute leukemias right away to stop the growth of the cancer and increase your chance of survival. For some chronic forms of leukemia, we may monitor you closely and wait to start treatment until your symptoms get worse. 

There are 5 main types of leukemia and dozens of subtypes:

• Acute lymphoblastic leukemia (ALL): Most common type of leukemia in children, especially between ages 2 and 5.
• Acute myeloid leukemia (AML): Can happen at any age but is more common in adults.
• Chronic lymphocytic leukemia (CLL): Almost always affects adults. It’s very rare in kids.
• Chronic myelomonocytic leukemia (CMML): Mostly found in older adults. Very rare in children.
• Chronic myelogenous leukemia (CML): Happens more often in adults but can rarely affect children too.

Lymphoma

Lymphomas originate in lymph tissue or lymph nodes. There are 2 main categories of lymphomas with dozens of subtypes:

• Hodgkin lymphoma: More common in teens and young adults, but can also affect children and older adults
• Non-Hodgkin lymphoma: Can happen at any age, but some types are more common in children and others in adults

An accurate diagnosis is essential for treating lymphomas. Almost all lymphomas are treatable and many are curable. 

Multiple Myeloma

Also known as myeloma, this blood cancer starts in plasma cells in the bone marrow. A healthy plasma cell produces antibodies—proteins that circulate in the body and serve many useful functions, including fighting infection.

The abnormal plasma cells multiply in multiple myeloma and do not die off normally. These cancerous plasma cells cause many problems throughout the body.

This type of blood cancer starts in the plasma cells, which help your body fight infections. It's very rare in kids and mostly affects older adults.

Myeloproliferative neoplasms

Other conditions like myeloproliferative neoplasms come into the category of blood cancers. These start in the bone marrow and cause the body to make too many mature blood cells.

There are different types, including:

• Polycythemia vera: Makes too many red blood cells
• Essential thrombocythemia: Makes too many platelets
• Primary myelofibrosis: Leads to scarring in the bone marrow

MPNs are usually chronic and progress slowly. They're more common in adults.

Accurate diagnosis is crucial in treating blood cancers. Our blood cancer doctors work with doctors who diagnose conditions from tissue samples (pathologists) to identify your cancer and find the best treatment plan.

Blood cancers can be very slow-growing or some of the fastest-growing cancers. For faster-moving cancers, you may need to be in the hospital during the diagnosis process and starting treatment. 

Our first goal of blood cancer treatment is remission—when there's no evidence of cancer. Eventually, we may declare the cancer cured, a word we love to use. Cured means that the cancer is completely gone. Often, we can do scans to show you’re in remission, but we won’t know if we’ve cured the cancer until much later.

Cancer medicines

Unlike other types of cancer, surgery is usually not the first option to treat blood cancers. We may do surgery to remove a lymph node and test the tissue or do other surgeries to relieve symptoms.

It may sound alarming, but blood cancer cells move around the body like normal white cells. For this reason, the usual therapy for blood cancer is medicine to kill or control the growth and spread of cancer cells. 

Every person’s blood cancer is unique and will need a personalized treatment plan.

Common cancer medicines we use to treat blood cancers include:

• Chemotherapy: These medicines kill fast-growing cells, such as cancer cells
• Immunotherapy: These medicines boost your immune system to fight cancer cells
• Targeted therapy: These medicines target cancers with specific features
• Stem cell transplant: Replaces damaged bone marrow with healthy stem cells after high-dose treatment
• CAR T-cell therapy: Uses your own immune cells, changed in a lab, to better fight cancer
• BiTE and other new therapies: These cutting-edge treatments help your immune system find and kill cancer cells in new ways

Radiation therapy

Our radiation oncology partners use high-energy rays to target and kill cancer cells. We may use radiation therapy to treat early-stage Hodgkin and non-Hodgkin lymphomas.

Clinical trials

Clinical trials are another way to fight cancer. We usually compare a new medicine or protocol to the current best therapy in a trial. Your care team may ask you to consider a trial when studying a new and exciting way to treat cancer.

These studies are voluntary; you'll talk to your care team before enrolling. A trial can be a first treatment option or an option if your conventional treatment stops working.