Cancer that begins in blood-forming tissue, such as the bone marrow, or in the cells of the immune system. Examples of hematologic cancer are leukemia, lymphoma, and multiple myeloma.

Leukemia is cancer of the blood cells. Most blood cells form in the bone marrow. In leukemia, cancerous blood cells form and crowd out the healthy blood cells in the bone marrow.

Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course.

Cancer that begins in the bone marrow. It is a cancer of plasma cells, which are a type of white blood cells (also called plasma B cells). It has several forms, including multiple myeloma, the most common form. More than 90 percent of people with myeloma have this type which affects several different areas of the body. Other forms are plasmacytoma, where only one site of myeloma cells evident in the body, such as a tumor in the bone, skin, muscle, or lung; localized myeloma; which is found in one site with exposure to neighboring sites; extramedullary myeloma; and which involves tissue other than the marrow, such as the skin, muscles or lungs. Doctors divide myeloma into groups that describe how rapidly or slowly the disease is progressing:

Asymptomatic or smoldering myeloma progresses slowly and has no symptoms even though the patient has the disease; symptomatic myeloma has related symptoms such as anemia, kidney damage and bone disease.

Risk Factors

There is currently no known way to prevent most types of leukemia, especially among children. Smoking is the most significant avoidable risk factor among adults. Also, avoiding chemicals linked with leukemia, such as benzene, may lower the risk of developing leukemia. Both children and adults who have been treated previously for cancer with radiation and chemotherapy, who are taking immune suppressing drugs, or who have certain genetic conditions such as Down’s Syndrome are at higher risk of developing acute leukemia.

Risk factors for both Hodgkin lymphoma and NHL include being male, having a weakened immune system, or being infected with human immunodeficiency virus (HIV) or Epstein-Barr virus. Infection with Helicobacter pylori or human T-cell leukemia/lymphoma virus type 1 (HTLV-1) increases the risk for certain types of NHL. The risk of NHL increases with age, whereas the risk of Hodgkin lymphoma is higher in both early adulthood and later life.

Doctors don’t know why some cells become myeloma cells and others don’t. For most people who have myeloma, there are no obvious reasons why they developed the disease. Some factors that may increase the risk of developing myeloma include being over age 50, a male and African American, as well as people with a history of MGUS (monoclonal gammopathy of unknown significance), exposure to radiation or certain types of pesticides, fertilizers and Agent Orange, or are obese.



  • Fever, chills and other flu-like symptoms
  • Weakness and fatigue
  • Frequent infections
  • Loss of appetite
  • Weight loss
  • Swollen or tender lymph nodes, liver or spleen
  • Easy bleeding or bruising
  • Tiny red spots under the skin
  • Swollen or bleeding gums
  • Sweating, especially at night
  • Bone or joint pain
  • Anemia


  • Enlarged lymph nodes
  • Swollen abdomen (belly)
  • Feeling full after only a small amount of food
  • Chest pain or pressure
  • Shortness of breath or cough
  • Fever
  • Weight loss
  • Night sweats
  • Fatigue (extreme tiredness)
  • Low red blood cell counts (anemia)


  • Bone problems (pain, weakness or fracture)
  • Low blood counts (Shortages of red blood cells, white blood cells, and blood platelets)
  • High blood levels of calcium
  • Nervous system symptoms
  • Nerve damage (weakness and numbness)
  • Hyperviscosity
  • Kidney problems


Leukemia is either acute or chronic. Acute leukemia is a fast-growing cancer that usually gets worse quickly. Chronic leukemia is a slower-growing cancer that gets worse slowly over time. The treatment and prognosis for leukemia depend on the type of blood cell affected and whether the leukemia is acute or chronic. Your health care provider may do one or more of the following procedures to determine if you have leukemia:

  • Complete medical history
  • Physical exam
  • Blood tests
  • Imaging tests such as x-rays, ultrasound, CT scan, MRI, bone scan
  • Bone marrow biopsy
  • Surgical lymph node biopsy
  • Lumbar puncture


  • Complete medical history
  • Physical exam
  • Blood tests
  • Imaging tests such as x-rays, ultrasound, CT scan, MRI, bone scan
  • Lymph node biopsy
  • Lab tests on biopsy samples to classify the type of lymphoma


  • Lab tests on blood and/or urine
  • X–rays of the bones
  • Bone marrow biopsy


Some of the treatments for these disorders include chemotherapy, apheresis, and in some hematologic malignancies, stem cell transplant. In addition, therapeutic apheresis procedures are adjunctive treatment for patients with hematological, neuromuscular, renal, rheumatological and autoimmune disorders.

The main type of treatment for leukemia is chemotherapy. This may be used alone or in combination with:

  • Bone marrow transplants
  • Radiation therapy
  • Interferon therapy (immunotherapy)
  • Surgery-splenectomy (removal of the spleen)

The treatment plan chosen is based on the type of leukemia, the patient’s age, white blood cell count, genetics of the cancer, and whether or not there was a preleukemic condition or a previously treated cancer.

Standard treatments for both types of lymphoma are chemotherapy, radiation therapy, and stem cell transplant. Additional standard therapies include surgery for Hodgkin lymphoma and targeted therapy, plasmapheresis, watchful waiting and biological therapy for NHL.


  • Chemotherapy, steroids and biological therapies
  • Radiation therapy (for pain control)
  • Bisphosphonates (to reduce bone damage)
  • High dose chemotherapy and stem cell transplant.

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