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Hematological malignancy

 

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Hematological malignancy



 
 
Hematological malignancies are the types of cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
 that affect blood
Blood

Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
, bone marrow
Bone marrow

Bone marrow is the flexible biological tissue found in the hollow interior of bones. In adults, marrow in large bones produces new blood cells....
, and lymph node
Lymph node

A Lymph node is an organ consisting of many types of cells, and is a part of the lymphatic system. Lymph nodes are found all through the body, and act as filters or traps for foreign particles....
s. As the three are intimately connected through the immune system
Immune system

An immune system is a collection of biological processes within an organism that protects against disease by identifying and killing pathogens and tumour cells....
, a disease affecting one of the three will often affect the others as well: although lymphoma
Lymphoma

Lymphoma is a type of cancer that originates in lymphocytes of the immune system. They often originate in lymph nodes, presenting as an enlargement of the node ....
 is technically a disease of the lymph node
Lymph node

A Lymph node is an organ consisting of many types of cells, and is a part of the lymphatic system. Lymph nodes are found all through the body, and act as filters or traps for foreign particles....
s, it often spreads to the bone marrow
Bone marrow

Bone marrow is the flexible biological tissue found in the hollow interior of bones. In adults, marrow in large bones produces new blood cells....
, affecting the blood
Blood

Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
 and occasionally producing a paraprotein
Paraprotein

A protein in the urine or blood, most often associated with benign Monoclonal gammopathy of undetermined significance , where they remain "silent", and multiple myeloma....
.

Chromosomal translocation
Chromosomal translocation

In genetics, a chromosome translocation is a chromosome abnormality caused by rearrangement of parts between nonhomologous chromosomes. A fusion gene may be created when the translocation joins two otherwise separated genes, an event which is common in cancer....
s are a common cause of these diseases, while this is uncommon in solid tumors.






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Encyclopedia


Hematological malignancies are the types of cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
 that affect blood
Blood

Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
, bone marrow
Bone marrow

Bone marrow is the flexible biological tissue found in the hollow interior of bones. In adults, marrow in large bones produces new blood cells....
, and lymph node
Lymph node

A Lymph node is an organ consisting of many types of cells, and is a part of the lymphatic system. Lymph nodes are found all through the body, and act as filters or traps for foreign particles....
s. As the three are intimately connected through the immune system
Immune system

An immune system is a collection of biological processes within an organism that protects against disease by identifying and killing pathogens and tumour cells....
, a disease affecting one of the three will often affect the others as well: although lymphoma
Lymphoma

Lymphoma is a type of cancer that originates in lymphocytes of the immune system. They often originate in lymph nodes, presenting as an enlargement of the node ....
 is technically a disease of the lymph node
Lymph node

A Lymph node is an organ consisting of many types of cells, and is a part of the lymphatic system. Lymph nodes are found all through the body, and act as filters or traps for foreign particles....
s, it often spreads to the bone marrow
Bone marrow

Bone marrow is the flexible biological tissue found in the hollow interior of bones. In adults, marrow in large bones produces new blood cells....
, affecting the blood
Blood

Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
 and occasionally producing a paraprotein
Paraprotein

A protein in the urine or blood, most often associated with benign Monoclonal gammopathy of undetermined significance , where they remain "silent", and multiple myeloma....
.

Chromosomal translocation
Chromosomal translocation

In genetics, a chromosome translocation is a chromosome abnormality caused by rearrangement of parts between nonhomologous chromosomes. A fusion gene may be created when the translocation joins two otherwise separated genes, an event which is common in cancer....
s are a common cause of these diseases, while this is uncommon in solid tumors. This leads to a different approach in diagnosis and treatment of hematological malignancies.

Although hematological malignancies are a form of cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
, they are generally treated by specialists in hematology
Hematology

Hematology, American_and_British_English_spelling_differences#Simplification_of_ae_.28.C3.A6.29_and_oe_.28.C5.93.29 haematology, is the branch of biology , pathology, clinical laboratory, internal medicine, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases....
, although in many hospitals oncology
Oncology

Oncology is the branch of medicine that studies tumors . A medical professional who practices oncology is an oncologist. The term originates from the Greek onkos , meaning bulk, mass, or tumor and the suffix -logy, meaning "study of"....
 specialists also manage these diseases. ("Hematology/Oncology" is a single subspecialty of Internal Medicine
Internal medicine

Internal Medicine is the medical specialty concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases. In North America, specialists in internal medicine are commonly called, "Internists." Elsewhere, especially in Commonwealth of Nations nations, such specialists are often called Physicians....
; there are also surgical and radiation oncologists.)

List of diseases

The hematological malignancies include:
  • Leukemia
    Leukemia

    Leukemia is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation of blood Cell , usually white blood cells ....
    :
    • Acute lymphoblastic leukemia
      Acute lymphoblastic leukemia

      Acute lymphoblastic leukemia , is a form of leukemia, or hematological malignancy characterized by excess lymphoblasts.Malignant, immature lymphoblasts continuously multiply and are overproduced in the bone marrow....
       (ALL)
    • Acute myelogenous leukemia (AML)
    • Chronic myelogenous leukemia
      Chronic myelogenous leukemia

      Chronic myelogenous leukemia , also known as chronic granulocytic leukemia , is a form of leukemia characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow and the accumulation of these cells in the blood....
       (CML)
    • Chronic lymphocytic leukemia
      Chronic lymphocytic leukemia

      B-cell chronic lymphocytic leukemia , is a type of leukemia, or cancer of the white blood cells . CLL affects a particular lymphocyte, the B cell, which originates in the bone marrow, develops in the lymph nodes, and normally fights infection....
       (CLL)
    • Hairy cell leukemia
      Hairy cell leukemia

      Hairy cell leukemia is a mature B cell neoplasm. It is usually classified as a sub-type of chronic lymphoid leukemia for convenience. It is uncommon, representing about 2% of all leukemias, or less than a total of 2000 new cases diagnosed each year in North America and Western Europe combined....
       (HCL)
  • Lymphoma
    Lymphoma

    Lymphoma is a type of cancer that originates in lymphocytes of the immune system. They often originate in lymph nodes, presenting as an enlargement of the node ....
    :
    • Hodgkin's disease (four subtypes)
    • Non-Hodgkin lymphoma
      Non-Hodgkin lymphoma

      The non-Hodgkin lymphomas are a diverse group of hematological malignancy which encompass any lymphoma other than Hodgkin lymphoma.Lymphoma is a type of cancer derived from lymphocytes, a type of white blood cell....
       (many subtypes)
  • Multiple myeloma
    Multiple myeloma

    Multiple myeloma is a cancer of plasma cells. These immune system cells are formed in bone marrow, are numerous in lymphatics and produce antibody....


Related disorders, which are generally not called "cancer":
  • Myelodysplastic syndrome
    Myelodysplastic syndrome

    The myelodysplastic syndromes are a diverse collection of hematology conditions united by ineffective production of myeloid blood cells and risk of transformation to acute myelogenous leukemia ....
     (MDS) - can culminate in AML
  • Myeloproliferative disease
    Myeloproliferative disease

    The myeloproliferative diseases are a group of diseases of the bone marrow in which excess cells are produced. They are related to, and may evolve into, myelodysplastic syndrome and acute myeloid leukemia, although the myeloproliferative diseases on the whole have a much better prognosis than these conditions....
    :
    • Polycythemia vera
      Polycythemia vera

      Primary polycythemia, often called polycythemia vera , polycythemia rubra vera , or erythremia, occurs when excess red blood cells are produced as a result of an abnormality of the bone marrow and occasionally in the kidneys....
       (PV, PCV or occasionally polycythemia rubra vera - PRV)
    • Essential thrombocytosis
      Essential thrombocytosis

      Essential thrombocytosis is a rare chronic blood disorder characterized by the myeloproliferative syndrome of platelets by megakaryocytes in the bone marrow in the absence of an alternative cause....
       (ET)
    • Myelofibrosis
      Myelofibrosis

      Myelofibrosis, also known as myeloid metaplasia, chronic idiopathic myelofibrosis, and primary myelofibrosis, is a disorder of the bone marrow, in which the marrow undergoes fibrosis - replacement by fibrous tissue ....
  • Amyloid
    Amyloid

    Amyloids are insoluble fibrous protein aggregates sharing specific structural traits. Abnormal accumulation of amyloid in organs may lead to amyloidosis, and may play a role in various other neurodegenerative diseases....
     due to light-chain disease


Diagnosis

For the analysis of a suspected hematological malignancy, a complete blood count
Complete blood count

A complete blood count , also known as full blood count or full blood exam or blood panel, is a test requested by a physician or other medical professional that gives information about the cells in a patient's blood....
 and blood film
Blood film

A blood film or peripheral blood smear is a microscope slide made from a drop of blood, that allows the cells to be examined microscopically....
 are essential, as malignant cells can show in characteristic ways on light microscopy. When there is lymphadenopathy
Lymphadenopathy

Lymphadenopathy is a term meaning "disease of the lymph nodes." It is, however, almost synonymously used with "swollen/enlarged lymph nodes".When the infection is of the lymph nodes themselves, it is called lymphadenitis, but when the infection is of the lymph channels, it is called lymphangitis....
, a biopsy
Biopsy

A biopsy is a medical test involving the removal of Cell_s or Biological tissues for examination. It is the removal of tissue from a living subject to determine the presence or extent of a disease....
 from a lymph node
Lymph node

A Lymph node is an organ consisting of many types of cells, and is a part of the lymphatic system. Lymph nodes are found all through the body, and act as filters or traps for foreign particles....
 is generally undertaken surgically
Surgery

Surgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, or sometimes for some other reason....
. In general, a bone marrow biopsy
Bone marrow biopsy

Bone marrow examination refers to the pathology analysis of samples of bone marrow obtained by bone marrow biopsy and bone marrow aspiration....
 is part of the "work up" for the analysis of these diseases. All specimens are examined microscopically to determine the nature of the malignancy. A number of these diseases can now be classified by cytogenetics
Cytogenetics

Cytogenetics is a branch of genetics that is concerned with the study of the structure and function of the cell, especially the chromosomes. It includes routine analysis of G banding chromosomes, other cytogenetic banding techniques, as well as molecular cytogenetics such as fluorescent in situ hybridization and comparative genomic hybridiz...
 (AML, CML) or immunophenotyping
Immunophenotyping

Immunophenotyping is a technique used to study the protein expressed by cells. This technique is commonly used in basic science research and laboratory diagnostic purpose....
 (lymphoma, myeloma, CLL) of the malignant cells.

Treatment

Treatment can occasionally consist of "watchful waiting" (e.g. in CLL
Chronic lymphocytic leukemia

B-cell chronic lymphocytic leukemia , is a type of leukemia, or cancer of the white blood cells . CLL affects a particular lymphocyte, the B cell, which originates in the bone marrow, develops in the lymph nodes, and normally fights infection....
) or symptomatic treatment (e.g. blood transfusion
Blood transfusion

Blood transfusion is the process of transferring blood or blood-based products from one person into the circulatory system of another. Blood transfusions can be life-saving in some situations, such as massive blood loss due to Physical trauma, or can be used to replace blood lost during surgery....
s in MDS
Myelodysplastic syndrome

The myelodysplastic syndromes are a diverse collection of hematology conditions united by ineffective production of myeloid blood cells and risk of transformation to acute myelogenous leukemia ....
). The more aggressive forms of disease require treatment with chemotherapy
Chemotherapy

Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer....
, radiotherapy, immunotherapy
Immunotherapy

Immunotherapy, in medicine, refers to an array of treatment strategies based upon the concept of modulating the immune system to achieve a Prophylaxis and/or Immunosuppressive therapy goal....
 and - in some cases - a bone marrow transplant
Bone marrow transplant

Hematopoietic stem cell transplantation is the transplantation of Pluripotential hemopoietic stem cell derived from the bone marrow or blood. Stem cell transplantation is a medical procedure in the fields of hematology and oncology, most often performed for people with diseases of the blood, bone marrow, or certain types of cancer....
.

Follow-up

If treatment has been successful ("complete" or "partial remission"), a patient is generally followed up at regular intervals to detect recurrence and monitor for "secondary malignancy" (an uncommon side-effect of some chemotherapy
Chemotherapy

Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer....
 and radiotherapy regimens - the appearance of another form of cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
). In the follow-up, which should be done at pre-determined regular intervals, general anamnesis
Medical history

The medical history or anamnesis J - jaundice T - tuberculosis H - hypertension & heart disease R - rheumatic fever...
 is combined with complete blood count
Complete blood count

A complete blood count , also known as full blood count or full blood exam or blood panel, is a test requested by a physician or other medical professional that gives information about the cells in a patient's blood....
 and determination of lactate dehydrogenase
Lactate dehydrogenase

Lactate dehydrogenase is an enzyme present in a wide variety of organisms, including plants and animals....
 or thymidine kinase
Thymidine kinase

Thymidine kinase TK, is an enzyme, a phosphotransferase : 2'-deoxythymidine kinase, ATP-thymidine 5'-phosphotransferase, . It can be found in most living cell s....
 in serum.