Blood cancers in adults

Summary/Epidemiology

Blood cancers or "hematological" cancers include five major families: leukemias, lymphomas, myeloproliferative syndromes, multiple myeloma, and myelodysplasias.

Leukemias are characterized by an excessive increase of white blood cells in the blood and in the bone marrow, the production center of blood cells whose normal development is impaired. Lymphomas are cancers of the lymphatic system, which is involved in the defense of the body, particularly against infections, and which includes, in addition to the bone marrow, the lymph nodes and various organs such as the spleen.

Myeloproliferative syndromes are caused by an exaggerated production of blood cells (red blood cells, white blood cells, and platelets) in the bone marrow. Myeloma is characterized by the proliferation of a particular type of white blood cell called plasma cells. Finally, myelodysplasias are preleukemic conditions.

The definite diagnosis of blood cancers is made through laboratory examinations. In our center, the specialists who carry out these sometimes complex diagnostic tests and the physicians who specialize in treatment pool their knowledge in multidisciplinary meetings. Each case is thus analyzed in depth, which makes it possible to define the most appropriate attitude.

The annual incidence of lymphoma in Belgium is 1200, that of acute leukemia is 300, and that of myeloma 400. Our Department of Hematology is a center of expertise in Belgium.

Risk factors

The occurrence of blood cancers is more frequent in subjects with diminished immunity. It is also promoted by excessive exposure to certain products or by their handling without basic precautions. These products include pesticides, insecticides, certain types of radiation, benzene, various solvents, and gasoline. Smoking is harmful to the blood as well as to other organs. There is little or no family or genetic influence.

Symptoms

Excessive bleeding, stubborn infections, pallor, enlarged lymph nodes, bone pain, or fracture after minor trauma may be warning signs. However, these signs are hardly specific: they can be found in several non-cancerous diseases.

The diagnosis therefore requires additional examinations.

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Diagnosis

Blood tests are performed to determine the concentration of red blood cells, white blood cells, and platelets, and to detect the presence of abnormal cells. If necessary, the work-up includes a microscopic examination of the bone marrow or lymph nodes. These examinations require a biopsy and lead to the diagnosis. Moreover, several research projects are underway to better understand the fine mechanisms that determine the behavior of hematological malignant cells, with a view to optimizing treatments.

Finally, PET scan can also be useful in the diagnosis. This is a state-of-the-art imaging technique that uses a marker to determine the location and activity of abnormal lymph nodes.

Treatments

Chemotherapy plays an important role in the treatment of leukemia and lymphoma. The treatment takes place partly in hospital, partly on an outpatient basis.

The specialists at the King Albert II Institute who deal with hematological cancers were the first in Belgium to propose this organization, which avoids the patient having to stay in hospital too long. Fifty to sixty patients are now treated daily in a "day hospital".

Bone marrow and blood stem cell transplants are performed when conventional treatment does not provide sufficient control of the disease. Allogeneic transplants consist of taking healthy marrow or blood stem cells from a compatible donor (often a sibling) and implanting them into the patient. In the case of an autologous transplant, the patient's own marrow is retrieved and transfused after intensive treatment.

The multidisciplinary team dedicated to hematological cancers was one of the first to use and successfully implement bone marrow transplantation. It remains at the forefront in this field.

Targeted therapies, such as infusions of antibodies and new drugs, are used in some blood cancers and are specific, meaning that they are active only on the cancer cells and preserve the rest of the body. They represent an important advance because they provide a benefit in terms of both efficacy and tolerance. These recent drug treatments are the subject of international studies in which reference centers such as ours are participating.

As a result of these advances, the prognosis of hematological cancers has improved considerably over the past few decades. Today's treatments can cure many cancers that were long considered fatal. However, some cancers are less responsive to treatment. Research undertaken at our center aims to elucidate the mechanisms governing this resistance to treatment, so that we can propose an optimal approach even in the most difficult cases. These complex studies require close collaboration between laboratory researchers and clinical physicians.

Research / Innovation

The collaboration between laboratory researchers and clinical physicians involved in large international studies allows us to benefit from the most up-to-date and effective treatments.

Contact

For any further information, or if you would like to make an appointment, please contact the Oncology Care Coordinator for Sacomas at + 32 2 764 17 16.

Doctor

Paramedical