What is blood cancer?

Blood cancer is an umbrella term for cancers that affect the blood, bone marrow and lymphatic system.

Unfortunately, blood cancer affects a large number of people. Every 20 minutes, someone in the UK is told they have a blood cancer. That’s 70 people a day, 25,000 people a year.

There are three main groups of blood cancer:

• Leukaemia
• Lymphoma
• Myeloma

Information on each group is below, with links to full details on each type of cancer. There is also general information on treatments for blood cancer.

Leukaemia

Leukaemia affects your white blood cells. These are an important, infection-fighting part of your immune system, made in your bone marrow.

If you have leukaemia, you produce an abnormal number of immature white blood cells which ‘clog up’ your bone marrow and stop it making other blood cells vital for a balanced immune system and healthy blood.

Acute leukaemia comes on suddenly, progresses quickly and needs to be treated urgently. Chronic leukaemia develops more slowly, over months or years.

There are four main types of leukaemia:

• Acute myeloid leukaemia (AML). It affects around 2,900 adults a year in the UK.  It’s most common in people over 70, although people of any age can get it.
• Acute lymphoblastic leukaemia (ALL). This is the most common type of leukaemia in children. ALL affects around 800 people a year in the UK. About half the cases are in adults and half in children.
• Chronic myeloid leukaemia (CML). It’s also quite a rare condition: only about 700 people every year are affected.
• Chronic lymphocytic leukaemia (CLL). Doctors diagnose just over 3,400 people with CLL a year in the UK. It’s more common to get it if you’re over 60 and is very rare in people under 40.

Other types of leukaemia include:

• acute promyelocytic leukaemia (APL)
• hairy cell leukaemia (HCL)
• large granular lymphocytic leukaemia (LGL)
• t-cell acute lymphoblastic leukaemia (T-ALL)
• chronic myelomonocytic leukaemia (CMML)

Lymphoma

Lymphoma is a type of blood cancer that affects your lymphatic system, an important part of your immune system which helps to protect your body from infection and disease.

If you have lymphoma it means you make too many lymphocytes, a type of white blood cell. Your lymphocytes also live longer than they should. This overload compromises your immune system.

Lymphoma can develop in many parts of your body, including your lymph nodes, bone marrow, blood, spleen and other organs.

The two main types of lymphoma are:

• Non-Hodgkin lymphoma (NHL). Most lymphomas are NHL – it’s the sixth most common cancer in the UK. Each year, around 13,000 people are diagnosed with it in the UK. It’s more common in older people – around 50% of people diagnosed with NHL are over 70.  
• Hodgkin lymphoma (used to be called Hodgkin disease). This is less common, and makes up less than 1% of all new cancers diagnosed in the UK. Around 1,900 people a year are diagnosed with Hodgkin lymphoma. Hodgkin lymphoma can develop at any age, but it’s most common in young adults and in older men and women.  

Myeloma

Myeloma (also called multiple myeloma) is a blood cancer of the plasma cells. Plasma cells are found in your bone marrow and produce antibodies which help fight infection.

In myeloma, unusually large numbers of abnormal plasma cells gather in your bone marrow and stop it producing an important part of your immune system.

In the UK, over 5,400 people are diagnosed with myeloma each year. The risk of myeloma increases as you get older – about 4 out of 10 (40%) of cases are in people aged over 70.

Myelodysplastic syndromes (MDS)

The myelodysplastic syndromes (MDS) are a group of blood disorders where a person’s bone marrow is not producing the correct amount and quality of blood cells. Red, white and platelet cells can be affected.

These problems lead to people with MDS feeling very tired, weak and bleeding or bruising more easily. There are different levels of severity of MDS; it’s not a type of leukaemia but can sometimes lead to acute myeloid leukaemia. MDS is rare – about 4 in every 100,000 people get MDS. It mainly affects older people, and is more common in people over 70 years old.

If you have low or intermediate risk MDS you may not need treatment straightaway, but regular blood transfusions and medication can help. Some people with more severe MDS can have chemotherapy and a small number of people may need to have a stem cell transplant

MDS Patient Support UK offers further information and support.

Treatments for blood cancer

When it comes to deciding on the best treatment, it all depends what type of blood cancer you have, how advanced and aggressive it is and your general health. Your doctor will suggest the most effective course of treatment for you. 

Common treatments are chemotherapy, radiotherapy and, in some cases, a stem cell or bone marrow transplant.

What is chemotherapy?

Chemotherapy involves taking drugs that destroy cancer cells, hopefully putting it into remission or significantly slowing down the progression of the disease.

There are many types of chemotherapy drugs and they work in different ways. Sometimes doctors will prescribe a single drug, but often they’ll recommend combining two or more because they often work better together. Chemotherapy can be used on its own, but it’s often combined with other treatments like radiotherapy. Chemotherapy is designed to attack cells that are growing and multiplying. That’s because cancer cells grow and multiply faster than healthy cells.

Some healthy cells can be caught in the crossfire, as they can also be growing and dividing quickly. This can cause side effects such as nausea, tiredness and hair loss.

If you’re getting ready for a stem cell, bone marrow or cord blood transplant, you’ll also need chemotherapy to suppress your immune system and stop it attacking your donor’s new ‘foreign’ cells. This is called conditioning therapy.

What is radiotherapy?

Radiotherapy works by using high-energy X-rays to kill cancer cells.

For it to be effective, doctors need to give just the right amount of radiation, targeted at the right area of the body. That’s why you get radiotherapy in specialist centres where doctors, physicists and radiographers work together. They’ll normally use a machine called a ‘linear accelerator’ for the treatment.

Radiotherapy can treat some types of leukaemia and lymphoma. Doctors can also use it to prepare a patient for a stem cell, bone marrow or cord blood transplant as part of the conditioning therapy. A low dose of radiation will lower someone’s immune system, so they’re less likely to reject donor cells. The type of radiotherapy you might have before a stem cell transplant is called total body irradiation or TBI and this means it affects the whole body.

Radiotherapy can also damage normal cells, which can cause side effects. These vary greatly for each person; some experiencing mild symptoms such as tiredness while for others it can be more debilitating.  These side effects will normally have passed within a few weeks of the treatment finishing.

When radiotherapy finishes, most of your body's healthy cells will continue to grow normally again. But radiotherapy can have long-term side effects.

Information published: 06/10/16
Next review due: 06/10/19