Most cancers are solid—a collection of mutated cells that grow out of control and form a tumor. The seven most common cancers—breast, lung, prostate, colorectal, melanoma, bladder and kidney—are solid cancers that account for nearly 1.3 million new diagnoses a year.
Cancers that are not considered solid cancers are often lumped together in the category of hematologic malignancies, or blood cancers: leukemia, lymphoma and myeloma. Hardly outliers, blood cancers account for more than 170,000 new diagnoses a year.
These cancers originate in blood, bone marrow and lymph, substances that interact so fluidly that the cancers that affect them may share common traits and symptoms. But each blood cancer has unique properties and often requires different treatments.
In this article, we’ll explore:
- The most common blood cancers
- What do bone marrow, blood and lymph do?
- Can one blood cancer lead to another?
If you’ve been diagnosed with a blood cancer, such as leukemia, lymphoma or multiple myeloma, and have questions about your treatment plan, or if you’re interested in a second opinion on your diagnosis, call us or chat online with a member of our team.
The most common blood cancers
The three main types of blood cancers are explained below.
Leukemia
In leukemia, the bone marrow produces mutated cells that spread to the blood, where they grow and crowd out healthy blood cells. Leukemia has many forms, but the key diagnosis is determined by whether the disease is acute or chronic.
Types of leukemia include:
- Acute lymphocytic leukemia (ALL)
- Acute myeloid leukemia (AML)
- Chronic lymphocytic leukemia (CLL)
- Chronic myeloid leukemia (CML)
- Hairy cell leukemia (HCL)
Acute leukemia is fast-growing and may require aggressive treatments, including:
While still serious diseases, some chronic leukemias are treatable, with patients experiencing positive outcomes. For instance, New York Mets pitcher Carlos Carrasco was diagnosed on 2019 with CML, but was back pitching in the major leagues less than a year later.
Leukemia is the 11th-most common cancer diagnosed in the United States.
Chart: Leukemia survival and prevalence by type
type |
new cases |
estimated deaths |
survival rate |
|---|---|---|---|
| ALL | 6,540 | 1,390 | 71 percent |
| AML | 20,380 | 11,310 | 32 percent |
| CLL | 18,740 | 4,490 | 88 percent |
Lymphoma
These diseases affect the cells in the lymphatic system.
In lymphomas, immune cells called lymphocytes grow out of control and collect in lymph nodes, the spleen, in other lymph tissues or in neighboring organs.
The disease is largely categorized as Hodgkin lymphoma, which is relatively rare, or non-Hodgkin lymphoma, which is the eighth-most common cancer diagnosed in the United States. It’s also the most common blood cancer.
The diseases are named for Dr. Thomas Hodgkin, the researcher who chronicled symptoms of the diseases almost 200 years ago.
Even though they share the Hodgkin name, the two diseases are quite different.
Hodgkin lymphoma is differentiated from the non-Hodgkin type by the presence of abnormal lymphocytes called Reed-Sternberg cells. These are large by cellular standards and may have at least two nuclei that give them the appearance of an owl's eyes.
Among other differences:
Average age of patients: Hodgkin lymphoma is diagnosed in younger patients, with an average age of 39; Non-Hodgkin lymphoma is diagnosed in patients with an average age of 67.
Types: Hodgkin lymphoma has four main types; Non-Hodgkin lymphoma has more than 30 types and subtypes.
Diagnoses: Hodgkin lymphoma is rare, accounting for about 0.4 percent of all new cancers; Non-Hodgkin lymphoma accounts for about 4 percent of all new cancer diagnoses.
Chart: Lymphoma survival and prevalence by type
| Lymphoma type | 2023 new cases | 2023 estimated deaths | Five-year survival rate |
|---|---|---|---|
| Hodgkin | 8,830 | 900 | 89 percent |
| Non-Hodgkin | 80,550 | 20,180 | 74 percent |
Multiple myeloma
This cancer develops in the bone marrow and affects plasma cells, which produce antibodies that attack infections and diseases.
When plasma cells become cancerous, they may accumulate in the marrow and damage or weaken bone and cause pain. Cancerous plasma cells also produce faulty antibodies, which make it hard for the body to fight infections.
Multiple myeloma may be referred to as just myeloma and is sometimes called plasma cell myeloma. The word “multiple” refers to the cancer’s tendency to accumulate in different parts of the body.
“This may lead to bone destruction,” says Tibor Kovacsovics, MD, Hematologic Oncologist at City of Hope Phoenix. “And the antibodies they produce may become abnormal, making patients more prone to infections.”
Chart: Multiple myeloma survival and prevalence
| 2023 estimated cases | 2023 estimated deaths | Five-year survival rate | |
|---|---|---|---|
| Multiple Myeloma | 35,730 | 12,590 | 60 percent |
What do bone marrow, blood and lymph do?
Blood: Blood regulates the flow of oxygen and carbon dioxide inside and outside the body, contains immune cells that fight infection and delivers nutrients and hormones.
Bone marrow: Red bone marrow produces new blood cells and platelets, which help regulate clotting. Yellow bone marrow produces and stores fats that help build bone and cartilage.
Lymph: Lymph fluids carry immune cells throughout the body, deliver bacteria to lymph nodes to be filtered out of the circulatory system and return excess proteins to the blood supply.
Patients with blood cancers often have symptoms common to all three forms of the disease, including:
- Weakness and fatigue
- Bone pain
- Infections
- Fevers
- Weight loss
- Bruising or bleeding
In fact, some leukemias and lymphomas are so similar, they may be considered the same disease, but are named depending on whether they’re found in the blood or in the lymph system. For instance, chronic lymphocytic leukemia and small lymphocytic lymphoma affect the same kind of cells—small lymphocytes—and are often considered different versions of the same disease. A definitive diagnosis may require a bone marrow biopsy or a procedure called flow cytometry, in which cancerous cells are analyzed with a laser.
Can one blood cancer lead to another?
Unfortunately, undergoing cancer treatment, even if it produces a positive outcome, doesn’t mean you won’t develop cancer again.
In some cases, a secondary cancer may develop independent of the first, or primary, cancer. In other cases, the second cancer may be a direct result of the original cancer or its treatment.
Cancer treatments may damage the immune system, the gut microbiome or DNA in cells that may lead to a second cancer.
Radiation therapy, for instance, may increase the risk of myelodysplastic syndrome (MDS), leukemia or other cancers. In 1970s and into the ’90s, doctors used mantle field radiation therapy to treat lymphoma. This type of therapy delivered radiation to a large section of the chest and neck to kill cancer cells in lymph nodes. Patients who were treated with mantle field radiation are at higher risk of developing a secondary cancer later in life. Mantle field radiation therapy is rarely used anymore.
Some types of chemotherapy, including the common drugs cisplatin and carboplatin, may also lead to higher risk of a secondary cancer.
“Sometimes, treating a cancer, including a blood cancer like lymphoma or multiple myeloma, may lead to a secondary condition,” Dr. Kovacsovics says. “For instance, the cells in the marrow may become damaged and may lead to a secondary malignancy called MDS or even leukemia. It's rare, but it can happen.”
MDS is a potentially serious form of cancer that occurs when immature cells in bone marrow fail to develop into healthy blood cells.
If you’ve been diagnosed with a blood cancer, such as leukemia, lymphoma or multiple myeloma, and have questions about your treatment plan, or if you’re interested in a second opinion on your diagnosis, call us or chat online with a member of our team.
