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Hematologic Cancers
Hematologic cancers are cancers of the blood or blood-forming tissues, such as bone marrow. Leukemia, lymphoma and multiple myeloma are the general types of hematologic cancers.
These cancers develop as a result of genetic errors in immature blood cells, known as stem cells. The stem cells reproduce themselves over and over again, leading to an overabundance of these abnormal blood cells, which are cancer cells that never mature, continue to proliferate uncontrollably and enter the bloodstream.
Within the past decade, physicians have made enormous progress in the treatment of hematologic cancers with new drugs, resulting in saved and prolonged lives and significantly improved quality of life for patients.
Acute lymphoblastic (or lymphocytic) leukemia (ALL) is a cancer arising in bone marrow. In people with ALL, abnormal stem cells develop into lymphoblasts or lymphocytes (white blood cells that fight infection) that are not able to fight infection well. As these cells increase in numbers in bone marrow and blood, they may cause anemia, infection and easy bleeding, and they may spread to the brain and spinal cord.
Chronic lymphocytic leukemia develops when the abnormal lymphocytes in bone marrow and lymph nodes multiply and replace normal lymphocytes over time. This type of leukemia develops slowly, and patients may have no symptoms in the early stages and little change in their health for many years. In time, such symptoms as fatigue, shortness of breath, swollen lymph nodes or spleen and repeated infections may occur.
Acute myeloid leukemia also arises in bone marrow, where abnormal stem cells develop into abnormal myoblasts (immature white blood cells) and sometimes into abnormal red blood cells or platelets (small blood cells). When they build up in bone marrow and blood, they cause the same symptoms as ALL and may also spread to the brain and spinal cord.
Hairy cell leukemia is a type of cancer in which abnormal lymphocytes are present in bone marrow, blood and the spleen. When these cells are looked at under a microscope, they appear to be covered with tiny hairs.
Hodgkin lymphomas are cancers that arise in the lymphatic system, a part of the body’s immune system made up of lymph vessels, lymph nodes, lymph fluid, the spleen, thymus, tonsils and bone marrow. Symptoms include painless enlargement of lymph nodes, the spleen or other tissues in the immune system, as well as fever, weight loss, fatigue and night sweats. The two major types of these lymphomas are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.
Nodular lymphocyte-predominant Hodg-kin lymphoma is a less common type of Hodgkin lymphoma, making up about 5 percent of all Hodgkin lymphomas. It is distinct from the other types, which are collectively called classical Hodgkin lymphomas and are classified into four subtypes based on the type of cells found in the patient’s lymph nodes, including nodular sclerosing subtype, mixed cellularity subtype, lymphocyte-rich subtype and lymphocyte-depleted subtype.
Non-Hodgkin lymphomas are a complex group of cancers also arising in the lymph system. These lymphomas are often marked by enlarged lymph nodes, fever and weight loss. Non-Hodgkin lymphomas may be aggressive or slow growing and classified as either B-cell or T-cell (types of lymphocytes) lymphomas. In addition to arising in lymph nodes, B-cell and T-cells lymphomas may also develop in other places in the body, such as the nasal sinuses.
The various types of B-cell non-Hodgkin lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma, small lymphocytic lymphoma, follicular lymphoma, precursor B-lymphoblastic lymphoma, MALT (mucosa-associated lymphoid tissue) lymphoma, lymphoplasmacytic lymphoma, nodal marginal zone lymphoma, splenic marginal zone lymphoma and mantle-cell lymphoma.
The various types of T-cell non-Hodgkin lymphomas include:
- adult T-cell lymphoma/leukemia
- mycosis fungoides
- anaplastic large-cell lymphoma
- cutaneous T-cell lymphoma
- precursor
- T-lymphoblastic lymphoma
- lymphoblastic
- lymphoma
- peripheral T-cell lymphoma
- angioimmunoblastic lymphoma
- angiocentric lymphoma (nasal T-cell lymphoma)
- intestinal T-cell lymphoma
- Sézary syndrome
Multiple myeloma is cancer that arises in plasma cells (white blood cells that produce antibodies to fight bacteria and viruses). Plasma cells are also known as myeloma cells. Multiple myeloma and other plasma-cell cancers develop when abnormal plasma cells are overproduced in bone marrow, preventing bone marrow from producing enough healthy blood cells. In patients with multiple myeloma, the abnormal plasma cells form tumors in many bones of the body.
Multiple myeloma may not cause any symptoms at all, but the symptoms that can develop include bone pain (especially in the back or ribs), bones that break easily, fever, frequent infections, easy bruising or bleeding, difficulty breathing, weakness of the arms or legs and feeling very tired.
Myelodysplastic syndromes are diseases characterized by stem cells that do not mature into healthy red and white blood cells or platelets but remain immature blood cells that do not function normally and die in bone marrow or as they enter the bloodstream. These cancers may cause anemia, infection and easy bleeding.
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