September marks Blood Cancer Awareness month. Some 14,000 people in the United States are diagnosed each month, accounting for 10% of new cancer cases. And while healthy children across the country are beginning their school year, we take pause to remember that kids are hit particularly hard by these diseases: Leukemias are the most common cancers in kids, accounting for 30% of all childhood cancers
But let’s back up: there are numerous types and kinds of these cancers, umbrellaed by their fluidity as leukemia, lymphoma, and myeloma. An excessive production of white blood cells in bone marrow leads to blood cancers, which often present with flu-like symptoms such as cough, chest pain, fever or chills and sweats, nausea, fatigue, shortness of breath, itchiness, and swollen lymph nodes. Other times, there are no apparent symptoms. With over 100 different types of blood cancer, early identification through laboratory tests is critical to determining an accurate diagnosis and establishing a treatment plan.
Early intervention—coupled with significant advances in treatment and technologies—has quadrupled the five-year relative survival rate for leukemia, specifically, since 1960. That’s certainly notable progress, but researchers, clinicians, and pathologists must continue their fight against all types of blood cancer.
Lymphomas are the most common blood cancers in adults, making up about half of all blood cancers. The lymphatic system and specifically lymph nodes are affected, impacting immune functioning. There are two main types: Hodgkin’s Lymphoma (HL) and non-Hodgkin’s Lymphoma (NHL).
Lymphoma (HL).The American Cancer Society predicts there will be over8,000 new cases of HL this year, and explains that while it can start anywhere, it commonly begins in the upper body lymph nodes (chest, neck or arms). People of any age can develop HL, but it’s most common in early adulthood; it’s the most commonly diagnosed teenage (15 to 19 years old) cancer. Incidence also rises after age 55. The 5-year relative survival rate for HL is about 86%.
Non-Hodgkin’s Lymphoma (NHL). NHL is more lethal than HL, with an estimated 20,000 U.S. deaths to occur this year. The WHO classifies subtypes of NL according to the type of lymphocyte thelymphoma starts in, how the lymphoma looks under a microscope, the chromosome features of the lymphoma cells, and the presence of certain proteins on the surface of the cells. With more than 60 different subtypes, there are a number of classification systems for identification. The treatment depends on what type of NHL the patient has, and how the cells are affected. Pathology is paramount.>
Leukemia begins in the blood and bone marrow, impacting the white blood cells which work to fight infection in the body. There are four main types:
Acute Lymphocytic Leukemia (ALL). ALL is the most common form of childhoodleukemia. It’s>aggressive, and without treatment, most patients would not live more than a few months. It accounts for>12% of all leukemia cases worldwide. Its diagnosis is typically made through blood and bone marrow tests to determine blood cell counts, blood chemistry studies and bone marrow sampling.
Acute myelogenous leukemia (AML). AML is common in adults, and is the second most common leukemia in kids. This type results from anover-proliferation of blood cells—white, red, and platelets—of myeloid lineage in the bone marrow (as opposed to lymphoid cells, which give rise to T cells and B cells). It can spread to organs and tissues easily. There are many subtypes of the disease, which kills about 10,000 people in the U.S. every year. Patients older than 60 do not usually respond well to treatments; the overall five-year survival rate for AML is just 26%, the lowest survival rate of all leukemias.
Chronic Myeloid Leukemia (CML).CML is a rare, slow-developing blood cancer that starts in the bone marrow, accounting for 10 to 15% of all leukemias.Almost half of those diagnosed are over age 65, through blood and bone marrow tests. Patients can live with CML for years, but the disease is difficult to cure.
Chronic Lymphocytic Leukemia (CLL). >CLL is the most common type of leukemia in adults, and takes on either a slow-growing or fast-growing form—which lab tests can differentiate. Symptoms can be mild and non-specific when progression is slow. Like CML, the patient can live with the disease for years, but the clinical path is usually more treatment than cure.
Myeloma is cancer of the plasma cells, a type of white blood cell made in the bone marrow. The immune system of myeloma patients is, of course, greatly compromised. Although considered rare, the American Cancer Society estimates that 32,110 cases will be diagnosed in 2019, with nearly 13,000 deaths expected.
The term “multiple myeloma” refers to the bone marrow being impacted in various bodily sites. In 70% of patients, the most common symptoms are back or bone pain, fatigue, and recurrent or persistent infections. There are no specific risk factors, so it’s difficult to know how to prevent this disease from developing. We do know who’s more likely to develop the disease: People over age 45 and men are more likely to have myeloma, and it’s more than twice as common among black people as among whites. Frontline treatment options include combination drug therapies.
Of the 172,910 U.S. patients with blood cancer, 36% have leukemia, 47% have a lymphoma and 18% have myeloma. Each type and subtype requires specific blood tests and biopsy analyses for classification, staging and treatment recommendations. Despite the progress we’ve made in the diagnosis and fight against blood cancer in recent decades, there is still much work to be done.-
In closing, life sciences companies, healthcare providers, insurance companies, and other stakeholders must play various roles in the fight against this disease. There is so much promise, especially with regard to precision medicine, to progress to more effective treatments. At Prognos, we see our value as harnessing advanced analytics from diagnostic laboratories along with data from medical claims to extract important information about disease progression, targeting, and therapies.
The industry must adopt new technologies, including machine learning and artificial intelligence solutions, to broaden its current scope disease understanding. Especially in aggressive cancers when every week—every day—counts, the ability to detect or even predict disease early is vital. Blood cancer patients need support: from one another, family, religious groups, neighbors, counselors, and everyone in the medical community. Inspired by the true fighters, let’s throw everything we’ve got at this disease.