What is blood cancer?
Blood cancers affect the bone marrow, which produces blood cells. It occurs as a result of mutations in blood cell DNA which leads to uncontrolled cell proliferation that affects the normal functioning of the body. This dysregulation usually affects white blood cells (WBCs), although more rare forms of blood cancer can involve increased red blood cells or platelets.
Key facts about blood cancers
In the UK, over 40,000 people per year are diagnosed with a blood cancer, and there are around 250,000 living with a blood cancer in the UK today. The overall incidence of blood cancers also increases with age, with around 40% of people diagnosed every year aged 75 or over. However, blood cancers are also the most common childhood cancer, accounting for 30% of cancer incidence in children under the age of 15 in industrialised countries (1).
What are the different types of blood cancer?
While there are over 100 different types of blood cancer, most belong to one of three main types: lymphoma, leukaemia and myeloma (2). Lymphomas are the most common, and affect WBCs called lymphocytes. Most lymphomas result from dysregulated proliferation of B cells, although T cells can be affected in more rare forms. Lymphomas are classified as either Hodgkin’s or non-Hodgkin’s, which differ in the type of lymphocytes affected and the disease course.
Leukemias affect WBCs in the bone marrow and can be either acute (fast growing) or chronic (slow growing). The most common leukemias are Chronic Lymphocytic Leukemia (CLL) and Acute Myeloid Leukemia (AML).
Myeloma is the third most common of the three main types of blood cancer and is a malignancy of plasma cells – the antibody secreting lymphocytes that mature from B cells in normal physiology.
Symptoms of blood cancer and the importance of diagnosis
There are multiple symptoms that are common to all blood cancers (2):
- Cough
- Unexplained bruising
- Pain in bone, joints or abdomen
- Frequent infection
- Tiredness
- Unexplained fever
- Unexplained rush
- Unexplained weight loss
- Shortness of breath
- Unusually pale complexion
- Drenching night sweats
- Lumps or swelling
Understanding the signs and symptoms of blood cancers means that patients can visit their doctor sooner, and begin treatment earlier. This is important because the stage of cancer at diagnosis is associated with survival in blood cancers. In Hodgkin’s lymphoma for example, the number of people alive 5 years after diagnosis decreases from 90% to 70% between stage 1 and stage 4 cancer (3).
How are blood cancers tested and diagnosed?
There are a range of tests to determine whether blood cancer is present and if so, which type the patient has. Blood tests such as full blood count, or liver or kidney function tests are widely-used, reliable methods. Biopsies of bone marrow or lymph nodes may also be taken, and pathologists observe this tissue under the microscope to determine whether cancerous cells are present. These blood samples or biopsies can also be used for genetic tests, which can give doctors a deeper understanding of which cancer is present and which treatment to use.
There are multiple scans that can be performed to test for blood cancer, which include CT, MRI, or PET scans, as well as X-rays and ultrasound. These scans allow doctors to look inside the body to determine whether a cancer is present and pinpoint its location. Another type of test is immunophenotyping, which uses flow cytometry to look at proteins on the surface of blood cells to help with diagnosis of blood cancer.
How are blood cancers treated?
While certain slow-growing blood cancers may not need immediate treatment, others will require medical intervention, which can include:
- Intravenous chemotherapy – often given in cycles of 1-week intensive treatment and 3 weeks with no treatment
- Stem cell transplants – given to replace dysfunctional stem cells in the bone marrow or replace healthy cells destroyed by chemotherapy
- Immunotherapy – works by enabling the patient’s own WBCs to find and kill cancer cells more easily
As a producer of advanced blood testing (haematology) analysers which are used to diagnose and monitor the treatment of patients with blood cancer, HORIBA understands the importance of providing patients with up-to-date information about their disease. This is why we work closely with our customers and partners and why we also produce a broad range of educational materials.
References:
- World Health Organization. Incidence of Childhood Leukaemia.; 2009. www.euro.who.int/__data/assets/pdf_file/0005/97016/4.1.-Incidence-of-childhood-leukaemia-EDITED_layouted.pdf
- Blood Cancer UK
https://bloodcancer.org.uk/ - Office for National Statistics. Cancer survival by stage at diagnosis for England, 2019. Published 2019. Accessed May 25, 2021.
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/cancersurvivalratescancersurvivalinenglandadultsdiagnosed