Bone marrow cancer is a complex group of haematological malignancies that can be life-threatening if not detected and treated promptly. Diseases like leukaemia, lymphoma, and myeloma originate right at the source of blood cell production and disrupt normal hematopoiesis. However, research has now uncovered valuable insights into the unique genetic and molecular characteristics of these cancers. The best medical oncologist in bangalore plays an important role in BMT. Bone marrow transplants are used to treat cancers like leukaemia, lymphoma, and multiple myeloma. Also blood disorders like aplastic anaemia, and sickle cell disease.
- Bone marrow is the spongy tissue inside bones where blood cells are produced.
- Bone marrow cancer refers to cancer that begins in the cells of the bone marrow.
- It is also called bone marrow neoplasm or haematological malignancy.
Types of Bone Marrow Cancers
- Leukaemia
- Starts in blood-forming cells of bone marrow resulting in excessive abnormal white blood cells.
- Acute leukaemias involve immature blood cells and progress quickly. Types are acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML).
- Chronic leukaemias involve more mature cells and progress slowly. Includes chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL).
- Symptoms include fatigue, weight loss, bleeding gums, and recurrent infections.
- Treatments include chemotherapy, targeted drugs like imatinib, and stem cell transplants.
2. Multiple Myeloma
- Cancer of plasma cells in bone marrow that produce antibodies.
- Malignant plasma cells accumulate in bones causing pain and fractures.
- Monoclonal protein spikes on lab tests help diagnose myeloma.
- Kidney dysfunction, anaemia, and repeated infections occur.
- Treatment involves chemotherapy, corticosteroids, stem cell transplant, and radiation.
3. Lymphomas
- Cancer of the lymphocytes or white blood cells in lymph nodes and other lymphoid tissues.
- Hodgkin lymphoma is marked by the presence of Reed-Sternberg cells. Non-Hodgkin lymphomas lack these cells.
- Symptoms include enlarged, painless lymph nodes, and unexplained weight loss.
- Chemotherapy, radiation, antibody drugs, surgery, and transplants are treatment options.
4. Myelodysplastic Syndromes
- Not cancer but disorders where bone marrow fails to produce enough healthy blood cells.
- Some types can transform into acute leukaemias over time.
- Cytopenias or low counts of one or more blood cell lines occur.
- Treatments include blood transfusions, growth factors, and low-dose chemotherapy.
Diagnosing Bone Marrow Cancer
- Blood Tests
- Complete blood count (CBC) to check levels of red cells, white cells, and platelets. Cytopenias signal bone marrow disorders.
- Peripheral blood smears to examine blood samples under a microscope for abnormal cells.
- Biomarker tests to check levels of proteins associated with cancers like myeloma.
2. Bone Marrow Tests
- Bone marrow aspiration involves using a needle to extract marrow fluid and cells from the hip bone.
- Bone marrow biopsy takes a small core sample of the actual bone and marrow with a needle.
- The sampled cells are examined by a hematopathologist to detect cancerous cells and their characteristics.
3. Imaging Tests
- X-rays, CT scans and PET scans create images of the body to see tumours or swollen lymph nodes indicating the spread of cancer.
- MRI scans provide detailed cross-sectional images of bone and bone marrow.
- A radionuclide bone scan tracks a radioactive tracer to detect bone lesions.
- Ultrasound uses sound waves to examine lymph nodes near the skin’s surface.
4. Other Tests
- Immunophenotyping analyzes antigens on the surface of cancer cells.
- Cytogenetics examines the chromosomes of cancer cells for genetic mutations.
- Lumbar puncture to obtain cerebrospinal fluid and check for cancer in the central nervous system.
Treating Bone Marrow Cancer
Treatment options available at Cytecare Cancer Hospital Bangalore :
Chemotherapy
- Uses cytotoxic drugs that kill rapidly dividing cancer cells. Can be injected, oral or intravenous.
- Chemotherapy regimens combine multiple drugs like vincristine, cyclophosphamide, doxorubicin, etc.
- Dosage and combinations based on type and stage of cancer.
- Causes side effects like nausea, hair loss, fatigue, and low blood counts.
Radiation Therapy
- Uses high-energy X-rays or protons externally or internally to shrink tumors.
- Often used before stem cell transplants or if cancer has spread to the brain or spine.
- Side effects include skin irritation, fatigue, and low blood counts.
Surgery
- Splenectomy to remove enlarged spleen in chronic leukaemia.
- Lymph node dissection in lymphoma to establish stage.
- Radical surgery is rarely done.
Stem Cell Transplant
- Autologous or allogeneic transplant to replenish marrow.
- Allows administration of high-dose chemotherapy.
- Carries risks of infections, and graft-versus-host disease.
Targeted Therapy
- Drugs that target specific cancer proteins and genes like BCR-ABL in CML.
- Examples: Imatinib, Rituximab, Bortezomib.
- More effective and less toxic than conventional chemotherapy.
Bone marrow cancers require prompt specialized treatment. With an experienced physician and personalized plan, remission and cure are possible.
Conclusion
Advancements in diagnostics like immunophenotyping and cytogenetics have enabled precise disease classification and staging. The treatment modalities have also expanded dramatically from conventional chemotherapy and radiation to targeted drugs, immunotherapy and stem cell transplants. While bone marrow cancers remain challenging to tackle, the prognosis for many patients has improved significantly. Moving forward, further research on bone marrow biology and the bone marrow microenvironment will open up new therapeutic targets. Emerging immunotherapies also hold promise for more effective and non-toxic treatments. With the availability of integrated care at cancer centres and support from haematologist-doctors, patients have a strong chance of achieving remission and long-term survival. Knowledge, precision, compassion and teamwork will continue to drive progress in combating these complex cancers.
