Malignant Hematology
At West Cancer Center, malignant hematologic cancers are treated using a team-based approach. Our specialists work together to provide personalized care for patients diagnosed with blood cancers, including leukemia, lymphoma, and multiple myeloma. Because every patient and diagnosis is unique, our team develops an individualized treatment plan focused on expert, compassionate care and the best possible outcomes.
Acute Myeloid Leukemia (AML)
Fast-growing cancer of myeloid cells.
Risk Factors
• Older age
• Prior chemotherapy or radiation
• Smoking
• Certain bone marrow disorders
• Inherited predisposition syndromes
Common Symptoms
• Fatigue
• Infections or fever
• Easy bruising or bleeding
• Shortness of breath
• Bone pain
• Unexplained weight loss
Diagnosis
• Complete blood count (CBC) and blood smear
• Bone marrow biopsy
• Flow cytometry
• Chromosome studies
• Molecular mutation testing
Treatment Options
• Intensive or lower-intensity chemotherapy
• Targeted drugs
• Stem cell transplant
• Supportive transfusions and infection care, based on patient and disease features
Chronic Myeloid Leukemia (CML)
Slow-growing cancer involving myeloid cells.
Risk Factors
• Usually caused by an acquired BCR::ABL1 genetic change
• Prior high-dose radiation exposure is a rare known risk factor
Common Symptoms
• Often found through routine bloodwork
• Fatigue
• Night sweats
• Unexplained weight loss
• Enlarged spleen or abdominal fullness
• Easy bleeding
Diagnosis
• CBC and blood smear
• BCR::ABL1 testing using:
• PCR
• FISH
• Chromosome analysis
• Bone marrow testing may help define the disease phase
Treatment Options
• BCR::ABL1 tyrosine kinase inhibitors are standard
• Stem cell transplant or other therapies for resistant or advanced disease
Acute Lymphoblastic Leukemia (ALL)
Fast-growing cancer of immature lymphoid cells
Risk Factors
• Certain inherited syndromes
• Prior chemotherapy or radiation
• Uncommon environmental or genetic factors
• Many cases have no known cause
Common Symptoms
• Fatigue
• Fever or infections
• Bruising or bleeding
• Bone or joint pain
• Enlarged lymph nodes
• Shortness of breath
• Neurologic symptoms
Diagnosis
• CBC and blood smear
• Bone marrow biopsy
• Flow cytometry
• Chromosome and molecular studies
• Lumbar puncture, when indicated
Treatment Options
• Multi-drug chemotherapy
• Targeted therapy
• Immunotherapy, such as:
• Blinatumomab
• CAR T-cell therapy
• Selected stem cell transplant
Chronic Lymphocytic Leukemia (CLL)
Slow-growing cancer of lymphocytes.
Risk Factors
• Older age
• Family history of CLL or related blood cancers
• Inherited susceptibility
Common Symptoms
• Often no symptoms
• Enlarged lymph nodes
• Fatigue
• Night sweats
• Recurrent infections
• Unexplained weight loss
• Enlarged spleen
Diagnosis
• CBC showing increased lymphocytes
• Flow cytometry
• Genetic and chromosome testing, such as:
• TP53
• IGHV
Treatment Options
• Observation for early, asymptomatic disease
• Targeted oral medications, when treatment is needed
• Antibody-based treatment regimens
Hodgkin Lymphoma
Identified by the presence of abnormal giant cells called Reed-Sternberg cells
Risk Factors
• Young or older adult age groups
• Prior Epstein-Barr virus infection
• Immune suppression
• Family history
Common Symptoms
• Painless enlarged lymph nodes
• Fever
• Drenching night sweats
• Unexplained weight loss
• Itching
• Fatigue
Diagnosis
• Lymph-node biopsy
• PET/CT staging
• CBC and other blood tests
• Selected bone marrow testing
Treatment Options
• Chemotherapy with or without radiation therapy
• Antibody-drug conjugates for relapsed disease
• Immunotherapy
• Stem cell transplant
• Other systemic therapies
Non-Hodgkin Lymphoma (NHL)
A large and diverse group of B-cell and T-cell lymphomas
Risk Factors
• Vary by subtype
• Older age
• Immune suppression
• Autoimmune disease
• Certain infections
• Family history
Common Symptoms
• Swollen lymph nodes
• Fever
• Night sweats
• Unexplained weight loss
• Fatigue
• Abdominal or chest symptoms
• Symptoms involving the affected organ
Diagnosis
• Tissue biopsy with immunophenotyping
• PET/CT or CT staging
• Blood tests
• Subtype-specific molecular and genetic studies
Treatment Options
• Observation
• Antibody therapy
• Chemotherapy
• Targeted drugs
• Radiation therapy
• Immunotherapy
• CAR T-cell therapy
• Stem cell transplant, depending on subtype
Multiple Myeloma
Uncontrolled growth of plasma cells that form tumors in the bone and produce high levels of abnormal proteins
Risk Factors
• Older age
• Black ancestry
• Male sex
• Family history
• Monoclonal gammopathy of undetermined significance (MGUS)
• Obesity
Common Symptoms
• Bone pain or fractures
• Anemia or fatigue
• Recurrent infections
• Kidney problems
• High calcium levels
• Numbness
• Weakness
Diagnosis
• Blood and urine protein studies
• Free light-chain testing
• Bone marrow biopsy
• Whole-body imaging
• Chromosome and genetic testing
Treatment Options
• Drug combinations that may include:
• Proteasome inhibitors
• Immunomodulatory drugs
• Antibodies
• Steroids
• Selected stem cell transplant
• Maintenance therapy
• Radiation therapy
• Newer cellular or bispecific therapies
Plasmacytomas and Monoclonal Gammopathy of Undetermined Significance (MGUS)
Conditions in which the bone marrow does not make enough healthy blood cells.
Risk Factors
• Older age
• Prior chemotherapy or radiation
• Smoking
• Benzene exposure
• Inherited bone marrow failure syndromes
Common Symptoms
• Fatigue
• Shortness of breath
• Infections
• Easy bruising or bleeding
• Other symptoms related to low blood counts
Diagnosis
• CBC and blood smear
• Bone marrow biopsy
• Chromosome testing
• Molecular mutation testing
Treatment Options
• Observation
• Supportive transfusions
• Growth factors
• Hypomethylating drugs
• Targeted therapy for selected subtypes
• Stem cell transplant for selected patients
Myelodysplastic Syndromes (MDS)
Conditions in which the bone marrow does not make enough healthy blood cells.
Risk Factors
• Older age
• Prior chemotherapy or radiation
• Smoking
• Benzene exposure
• Inherited bone marrow failure syndromes
Common Symptoms
• Fatigue
• Shortness of breath
• Infections
• Easy bruising or bleeding
• Other symptoms related to low blood counts
Diagnosis
• CBC and blood smear
• Bone marrow biopsy
• Chromosome testing
• Molecular mutation testing
Treatment Options
• Observation
• Supportive transfusions
• Growth factors
• Hypomethylating drugs
• Targeted therapy for selected subtypes
• Stem cell transplant for selected patients
Myeloproliferative Neoplasms (MPN)
Chronic disorders, such as polycythemia vera and essential thrombocythemia, that cause overproduction of blood cells.
Risk Factors
• Usually driven by acquired JAK2, CALR, or MPL mutations
• Older age
• Rare familial predisposition
Common Symptoms
• Headache
• Fatigue
• Itching
• Night sweats
• Blood clots or bleeding
• Enlarged spleen
• Abdominal fullness
• Symptoms related to abnormal blood counts
Diagnosis
• CBC and blood smear
• JAK2, CALR, and MPL testing
• Other molecular studies
• Bone marrow biopsy, when needed
Treatment Options
• Aspirin
• Phlebotomy
• Medicines that lower blood counts
• JAK inhibitors
• Interferon
• Symptom management
• Selected stem cell transplant, based on subtype and risk