Also known as hematologic cancers, it disrupts the normal production of blood cells and most of them develop in the bone marrow but can also affect the blood itself or the lymphatic system. Three main types of blood cancer are leukemia, lymphoma (Hodgkin lymphoma and Non-Hodgkin lymphoma) and myeloma. Although the exact cause of blood cancer is not known, it is associated with family history, weakened immune system, exposure to certain infections and with aging. The treatment for blood cancer is based on the type of cancer, the age of the affected individual and the progression of cancer. In some cases, complete eradication of the disease is possible while in other cases, the therapies are focused on the management of cancer. Research and treatment options have advanced from once toxic treatments to now more of targeted therapies. Genomic medicine, although in its early stage of development, shows promise in the risk assessment, early detection and individual tailored treatment in the future.

According to American Cancer Society, in the United States alone, an estimated 60,300 new cases of leukemia will be diagnosed in 2018. This form of cancer is diagnosed among adults at 20 years of age and older. The incidence trends show that leukemia has increased from 2005 to 2014 by 1.6% per year. It is found in the blood and the bone marrow and develops as the result of a rapid proliferation of abnormal white blood cells which are not able to fight off infections effectively. It also affects the ability of the bone marrow to normally produce red blood cells and platelets. Some of the common symptoms of leukemia include bruising and bleeding, the risk of infection, fatigue and fever. There are several types of leukemia with some form affecting the children mostly and others the adults.

Also, environmental and genetic factors appear to play an important role in the development of the disease. The four primary forms of leukemia are; acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). There is no cure for chronic lymphocytic leukemia and the primary management of the disease is based on suppressing cancer rather than eliminating it with the combination of chlorambucil, cyclophosphamide with chemotherapy along with a corticosteroid.

Latest Research: Identifying new treatment for leukemia is considered an important aspect of current researches. Various new drugs such as the T-cell-specific drug nelarabine and the antibody epratuzumab are being studied with the hope of delivering better cure rate in the future. Also, the possibility of other new treatments such as chemotherapy, antibodies and biologically active treatments are currently under research which can increase the cure rates, with hopefully, lesser side effects. Also, various trials are underway to reduce the symptoms by improving the patient’s quality of life.

Lymphoma

According to the American Cancer Society, in the United States, around 83,180 new cases of lymphoma will be diagnosed in 2018. It is the most common forms of blood cancer affecting the lymphatic system responsible for the production of immune cells. Abnormal lymphocytes develop into lymphoma cells which proliferate and collect in the lymph nodes affecting other parts of the body such as the spleen and the bone marrow.  The three main types affecting lymphocytes are; chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL/SLL), Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). CLL/SLL is the same forms of cancer with slightly different manifestations, there are six types of HL which are uncommon involving the Reed-Sternberg cells and there are more than 90 types of HNL which do not involve the Reed-Sternberg cells.

Latest Research: As new treatment options for two of the most common forms of cutaneous T-Cell lymphoma, U.S. Food and Drug Administration (FDA) has approved the treatment of Mogamulizumab-kpkc (Poteligeo) for adults with relapsed or refractory mycosis fungoides (MF) or Sezary syndrome (SS). In the clinical trial conducted, it showed that patients taking mogamulizumab had progression-free survival for longer compared to those taking a type of chemotherapy called vorinostat. Also, for frontline treatment of peripheral T-Cell lymphoma (PTCL), recently, FDA has approved Brentuximab vedotin (ADCETRIS) injection in combination with chemotherapy for adult patients. This is an antibody-drug conjugate (ADC) directed to CD30 that is expressed by several types of PTCL.

Myeloma

Also known as multiple myeloma, it is a cancer of the white blood cells (plasma cells) which are essential for the production of antibodies used by the body to fight off infections. Therefore, with myeloma, the normal developments of antibodies are affected leaving the body vulnerable to infections. This means the affected individuals are more prone to frequent infections, bleeding and bruising easily. Also, myeloma cells secrete chemicals that can result in the removal of calcium from the bone (osteoclasts) making them more brittle, weaker and could fracture easily. The types of myeloma are based on how the disease affects the plasma cells and in a majority of cases; it is detected in multiple bone marrows. Some of the types of myeloma are; Igg myeloma, IgA myeloma and Bence Jones myeloma.

Latest Research: Investigational drug Selinexor appears to show promising results as a treatment option for those with multiple myeloma who have exhausted all approved therapies. The trial shows that more than a quarter of the affected individuals has responded to the treatment lasting an overall survival as 8.6 months. This drug is an inhibitor of the XP01 protein which prevents abnormal cell proliferation and causes the death of cancer cells. Also, recently FDA approved carfilzomib (Kyprolis, Amgen) in combination with dexamethasone for individuals with relapsed or refractory multiple myeloma. The trial results indicate that once-weekly carfilzomib shows progression-free survival in comparison with the twice-weekly regimen.

Future of Genomics

Although research in the field of blood cancer has resulted in improved therapies, novel agents are being identified with the strategy of targeting the tumor. The potential blood biomarkers for cancer could also help reduce the invasive procedures and the genomic advances are enabling medicine to investigate cancer at a molecular level. The cancer genome research offers hope in the future where most cancers could be treatable chronic diseases managed with more personalized medicines.