West Cancer Center & Research Institute is positioned as the region’s comprehensive leader in adult cancer care and research. Our team at West offers unparalleled Malignant Hematology treatment for patients across the Mid South–from screening to survivorship- to provide your patients with the most individualized care possible.
Leukemia is a cancer of the body’s blood-forming tissues, including the bone marrow and the lymphatic system. Many types of leukemia exist. Leukemia usually involves the white blood cells. The white blood cells are potent infection fighters — they normally grow and divide in an orderly way, as the body needs them. But in people with leukemia, the bone marrow produces abnormal white blood cells, which don’t function properly.
Symptoms of Leukemia
- Fever or chills
- Persistent fatigue, weakness
- Frequent or severe infections
- Losing weight without trying
- Swollen lymph nodes, enlarged liver or spleen
- Easy bleeding or bruising
- Recurrent nosebleeds
- Tiny red spots in your skin (petechiae)
- Excessive sweating, especially at night
- Bone pain or tenderness
If you have a patient experiencing any of these symptoms, we urge you to reach out to your hematologic cancer specialist.
Diagnosis for Leukemia
At West Cancer Center, our Hematologic Oncology Specialist may find chronic leukemia in a routine blood test, before symptoms begin. If this happens, or if your patient has signs or symptoms that suggest leukemia, we may offer the following diagnostic exams:
- Physical exam.Your doctor will look for physical signs of leukemia, such as pale skin from anemia, swelling of your lymph nodes, and enlargement of your liver and spleen.
- Blood tests.By looking at a sample of your blood, your doctor can determine if you have abnormal levels of red or white blood cells or platelets — which may suggest leukemia.
- Bone marrow test.Your doctor may recommend a procedure to remove a sample of bone marrow from your hipbone. The bone marrow is removed using a long, thin needle. The sample is sent to a laboratory to look for leukemia cells. Specialized tests of your leukemia cells may reveal certain characteristics that are used to determine your treatment options.
Treatments for Leukemia
Treatments we provide for leukemia depends on many factors based on the patients age and overall health, the type of leukemia, and whether it has spread to other parts of the body, including the central nervous system.
Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells.
Depending on the type of leukemia, your patient may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein.
Biological therapy works by using treatments that help your patient’s immune system recognize and attack leukemia cells.
Targeted therapy uses drugs that attack specific vulnerabilities within the specific cancer cells.
For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease.
Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, the patient lies on a table while a large machine moves around , directing the radiation to precise points on the body body.
They may receive radiation in one specific area of the body where there is a collection of leukemia cells, or receive radiation over the entire whole body. Radiation therapy may also be used to prepare for a stem cell transplant.
STEM CELL TRANSPLANT
A stem cell transplant is a procedure to replace the diseased bone marrow with healthy bone marrow.
Before a stem cell transplant, your patient will receive high doses of chemotherapy or radiation therapy to destroy their diseased bone marrow, then receive an infusion of blood-forming stem cells that help to rebuild bone marrow.
Some patients receive stem cells from a donor, or may be able to use their own stem cells. A stem cell transplant is very similar to a bone marrow transplant.
Lymphoma is a cancer of the lymphatic system, which is part of the body’s germ-fighting network. The lymphatic system includes the lymph nodes (lymph glands), spleen, thymus gland and bone marrow. Lymphoma can affect all those areas as well as other organs throughout the body.
To understand what Hodgkin lymphoma is, it helps to know about the lymph system (also known as the lymphatic system). The lymph system is part of the immune system, which helps fight infections and some other diseases. The lymph system also helps control the flow of fluids in the body.
The lymph system is made up mainly of cells called lymphocytes, a type of white blood cell. There are 2 main types of lymphocytes:
- B lymphocytes (B cells): B cells make proteins called antibodies to help protect the body from germs (bacteria and viruses).
- T lymphocytes (T cells): There are many types of T cells. Some T cells destroy germs or abnormal cells in the body. Other T cells help boost or slow the activity of other immune system cells.
Hodgkin lymphoma usually starts in B lymphocytes.
Although Hodgkin lymphoma can start almost anywhere, most often it starts in lymph nodes in the upper part of the body. The most common sites are in the chest, neck, or under the arms.
Hodgkin lymphoma most often spreads through the lymph vessels from lymph node to lymph node. Rarely, late in the disease, it can invade the bloodstream and spread to other parts of the body, such as the liver, lungs, and/or bone marrow.
Different types of Hodgkin lymphoma can grow and spread differently and may be treated differently:
- Classic Hodgkin Lymphoma: Classic Hodgkin lymphoma (cHL) accounts for more than 9 out of 10 cases of Hodgkin lymphoma in developed countries. It has 4 subtypes: nodular sclerosis Hodgkin lymphoma (NSCHL), mixed cellularity Hodgkin lymphoma (MCCHL), lymphocyte-rich Hodgkin lymphoma, and lymphocyte-depleted Hodgkin lymphoma.
- Nodular Lymphocyte-Predominant Hodgkin Lymphoma: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) accounts for about 5% of cases. The cancer cells in NLPHL are large cells called popcorn cells (because they look like popcorn), which are variants of Reed-Sternberg cells. You may also hear these cells called lymphocytic and histiocytic (L&H) cells. NLPHL usually starts in lymph nodes in the neck and under the arm. It can occur in people of any age, and is more common in men than in women. This type of HL tends to grow more slowly and is treated differently from the classic types.
Symptoms of Lymphoma
If you are experiencing any of these symptoms, we urge you to speak to your provider as soon as possible for further examination.
- Painless swelling of the lymph nodes in your neck, armpits, or groin
- Persistent fatigue
- Night sweats
- Shortness of breath
- Unexplained weight loss
If your patient has any persistent signs or symptoms listed above please refer to one of our hematologic oncology specialists.
Diagnostic Procedures for Lymphoma
- Physical Exam: We checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver.
- Lymph Node Biopsy: A lymph node biopsy procedure may be recommended to remove all or part of a lymph node for laboratory testing. Advanced tests can determine if lymphoma cells are present and what types of cells are involved.
- Blood Tests: Blood tests to count the number of cells in a sample of the blood can provide clues about the diagnosis.
- Bone Marrow Biopsy: A bone marrow aspiration and biopsy procedure involves inserting a needle into the hipbone to remove a sample of bone marrow. The sample is analyzed to look for lymphoma cells.
- Imaging Tests: We may recommend imaging tests to look for signs of lymphoma in other areas of your body. Tests may include CT, MRI and positron emission tomography (PET).
Treatment Plans for Lymphoma
What lymphoma treatment is best for your patient depends on the lymphoma type and its severity. Lymphoma treatment may involve chemotherapy, immunotherapy medications, radiation therapy, a bone marrow transplant or some combination of these.
Some forms of lymphoma are very slow growing. We may decide to wait to treat your patient’s lymphoma when it causes signs and symptoms that interfere with daily activities. Until then, we may periodically tests to monitor the condition.
Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs we prescribe
OTHER DRUG THERAPY
Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in the cancer cells. Immunotherapy drugs use the immune system to kill cancer cells.
Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells.
BONE MARROW TRANSPLANT
A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress the bone marrow. Then healthy bone marrow stem cells from the patient’s body or from a donor is infused into the blood where they travel to the bones and rebuild the bone marrow.
Myeloma is cancer of the plasma cells. Plasma cells are white blood cells that produce disease- and infection-fighting antibodies in the body. Myeloma cells prevent the normal production of antibodies, leaving the body’s immune system weakened and susceptible to infection.
The multiplication of myeloma cells also interferes with the normal production and function of red and white blood cells. An abnormally high amount of these dysfunctional antibodies in the bloodstream can cause kidney damage. Additionally, the myeloma cells commonly produce substances that cause bone destruction, leading to bone pain and/or fractures.
Myeloma cells are produced in the bone marrow, the soft tissue inside the bones. Sometimes myeloma cells will travel through the blood stream and collect in other bones in the body. Because myeloma frequently occurs at many sites in the bone marrow, it is often referred to as multiple myeloma.
Though there is currently no known cure, West Cancer Center has dedicated a Blood and Marrow specialty treatment and research department to care for all multiple myeloma patients and their families. We are able to offer the latest therapies, ongoing surveillance, and management for those with MGUS, smoldering myeloma, and symptomatic myeloma.
Symptoms of Myeloma
Signs and symptoms of myeloma can vary and, early in the disease, there may be none.
When signs and symptoms do occur, they can include:
- Bone pain, especially in the spine or chest
- Loss of appetite
- Mental fogginess or confusion
- Frequent infections
- Weight loss
- Weakness or numbness in the legs
- Excessive thirst
If you have a patient with any persistent signs and symptoms show in the list above, please refer to one of our hematologic oncology specialists.
Diagnosis of Myeloma
To find out if there are abnormal plasma cells in the bone marrow, a bone marrow biopsy has to be done. In patients with multiple myeloma, they often have a monoclonal protein in their blood, which is a marker for the number of plasma cells in their bone marrow.
Monoclonal protein can be measured in 3 ways:
- Serum protein electrophoresis (SPEP)
- Quantitative immunoglobulins (QIMG)
- Serum free light chains (SFLC)
To have multiple myeloma, the plasma cells must cause damage to your body. There are four major ways this can happen and they are called the CRAB criteria. The first three types of damage can be measured from the blood, but the bone lesions require an x-ray or MRI.
Treatment Plans for Myeloma
There is no cure for myeloma, but with treatment, people can live for many years. The goal is to knock down the plasma cells and maintain them at low or undetectable levels. Unfortunately, despite being undetectable, they always eventually return.
Some of the medications used are older chemotherapies, but also include newer medicines, which can be taken as pills. If possible, an *autologous stem cell transplant is used to achieve a deep remission after a period of chemotherapy.