Blood Cancer - Types and Diagnosis

Out of 15 lakhs new cancer cases detected every year in our country, there are over 1 to 1.5 lakh are blood cancers. At the outset, I want to state that most of these blood cancers have high cure rates. Blood cancers include leukemia, lymphoma and myeloma.

Blood Cancers types

• Acute or aggressive blood cancers
• Chronic or low-grade blood cancers

Since acute blood cancers are rapid onset so it should be treated quickly otherwise it can cause death of the child due to bleeding, infections and lack of blood. Acute leukaemia is of many types but the two main types are Acute Myeloid Leukaemia (AML) and Acute Lymphoblastic Leukemia (ALL). Lymphoma are divided into Non-Hodgkin and Hodgkin Lymphoma which in turn are high-grade and low-grade lymphomas.

Chronic blood cancers are slow growing and one can live with disease for long duration with medicine. 

Causes of blood cancers are not known but following are the risk factors: – Chemical Pesticides, Radiations and some genetic reasons are also there. 

Blood circulates throughout the body. It supplies oxygen and nutrients to all organs. Blood is made up of plasma (the liquid that transports cells, waste and nutrients,) and blood cells.

Blood cells have 3 main components: –

RBC- Red Blood Cells are commonly known as red blood which supplies oxygen to your body’s tissues and organs.

WBC- white blood cells protects our body from infections

Platelets– protect our body from excessive bleeding  

Uncontrolled growth of WBC causes blood cancer or leukaemia. Since these rapidly growing WBC are abnormal, so they cannot fight infections and at the same time they clog the bone marrow where all blood cells are formed with the result Hb and platelets are suppressed. 

Due to this, the symptoms of acute leukaemia are vague like –

• Prolonged fever, Repeated infections, abnormal WBC
• Fatigue \ Nausea- due to decreased Hb
• Easy Bruising, Bleeding, Red Spots
• Enlargement of Nodes and night sweats
• Other blood cancers like myeloma may show no symptoms and slowly progress over years.

Due to vague symptoms there is delay of diagnosis at primary level care centres and by local Doctors. If you have these symptoms, please do not ignore and consult your doctor or medical oncologist immediately

Diagnoses of Blood Cancer

To diagnose blood cancer following tests are done-

1. CBC – Complete haemogram. In acute leukemia usually haemoglobin is low, WBC’s may be high or low and Platelets are lower than normal count. 
2. PBS- peripheral blood smear. PBC is done to differentiate between Acute and Chronic Leukaemia. Depending on PBS which tells us likely type of leukemia, we procced for further test to confirm type of leukemia 
3. Bone marrow aspiration and biopsy- in this blood is extracted by needle from bone of back (ileum) or sternum send for FCM (flowcytometry) and cytogenetics.
4. Lymph node biopsy

These tests are important firstly to find exact type of cancer as different cancer, as different type of blood cancers have different treatments and secondly to risk stratify – with means that every patient recieves treatment as per risk. Since treatment of cancer can itself cause side effects which can be long lasting and also as the cure rates are very high, so low risk leukemia are given milder treatment and only high risks are given strong treatment and with acceptable side effects.