As we mark Leukemia and Lymphoma Awareness Month in September, it’s a good time to discuss some of the signs of these blood cancers, along with the symptoms to look out for and some of the new treatment options available for patients.
Michael Keng
Leukemia: Affecting blood cells
Leukemia attacks stem cells, the building blocks of the body. Stem cells turn into other specialized cells, including the ones in the bloodstream: red blood cells, white blood cells and platelets.
The type of cells attacked by the leukemia will determine the kinds of symptoms patients experience in about 60% to 70% of cases. If red blood cells are affected, patients will feel more tired. When white blood cells are affected, patients will experience more infections, while an attack on platelets will leave patients with leukemia more susceptible to bleeding and bruising. In about 20% to 30% of leukemia cases, patients don’t experience symptoms, and the cancer is detected during routine blood tests.
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Treatment often begins with chemotherapy, which is sometimes combined with immunotherapy (where the body’s immune system is boosted to help fight leukemia). In many cases, patients require an allogeneic stem cell transplant, where a donor provides healthy stem cells to replace the blood cells damaged by the leukemia.
For a specific type of leukemia called acute lymphoblastic leukemia, clinical trials are examining the use of chimeric antigen receptor (CAR) T-cell therapy, which genetically modifies a type of white blood cell called T-cells to make them more effective cancer killers, as a potential treatment.
Lymphoma: Affecting lymph nodes
Lymphoma attacks lymph nodes, which are found across the body in areas such as the groin, armpit and neck. These nodes help the body’s immune system function properly and fight off infections. Patients with lymphoma will often experience a range of symptoms that include swelling or lumps in the lymph nodes, night sweats, fevers of an unknown origin and an unexpected loss of 10% to 15% of body weight over two to three months.
Treatment options typically include chemotherapy, immunotherapy and radiation therapy. Autologous stem cell transplants — which use the patient’s own healthy stem cells as a replacement for cells damaged by the lymphoma — are also an option for some patients, as is CAR T-cell therapy. Surgery to remove the lymph nodes is performed in rare circumstances.
How UVa Health and UVa Cancer Center can help
At UVa Health and UVa Cancer Center, we have multidisciplinary teams of experts specializing in each of these cancers. For example, the cancer I focus on treating is leukemia, and I work together with a team of leukemia specialists — including nurse practitioners, nurse care coordinators, pharmacists, clinical trial coordinators and pathologists — to provide excellent care. Our experts meet weekly at a tumor board to discuss each patient’s case and plan an individualized treatment course.
As a National Cancer Institute-designated Comprehensive Cancer Center, we also have access to the latest clinical trials examining potential treatments, including CAR T-cell therapy.
For more information about leukemia, lymphoma and other blood cancers, visit uvahealth.com/services/blood-cancer.
Dr. Michael Keng is a hematologist-oncologist at UVa Health and UVa Cancer Center whose specialties include caring for patients with leukemia.
