Hematological Malignancies

Hematological malignancies are diseases resulting from tumor growth (neoplasia) within the lymphoid and hematopoietic tissues — those involved with immune response and blood cell formation. The most commonly encountered types include:

  • Acute myeloid leukemia (AML) – Abnormal proliferation of the myeloid cell line, resulting in myeloblasts that invade bone marrow and hinder normal blood cell production
  • Chronic lymphocytic leukemia (CLL) – Develops from uncontrolled growth of immature lymphocytes (white blood cells) in bone marrow; patients can be asymptomatic for years before metastasis to lymph nodes, liver, spleen, other tissues and organs
  • Non-Hodgkin’s lymphoma (NHL) – Results from unregulated growth and proliferation of B-cells, T-cells or natural killer cells within the lymph nodes or lymphatic tissue of organs such as the stomach, intestines or skin
  • Multiple myeloma – A cancer of bone marrow plasma cells responsible for antibody (immunoglobulin) creation; most often originates in marrow of the skull, spine, ribs, hips and shoulders; can manifest as areas of bone loss called “lytic lesions”

Treatments: Evolving approaches

Conventional treatments for hematological malignancies have included:

  • Chemotherapy (the use of drugs to kill cancer cells)
  • Radiation therapy (the use of high-energy x-rays, protons or charged ions to inhibit and kill cancer cells)
  • Steroids (to reduce immune and inflammatory responses)
  • Bone marrow transplantation (destruction and replacement with healthy bone marrow)

More recently, however, research focused on new immunotherapies has yielded several potential new agents and strategies for blood and lymphatic cancer treatment that may prove less toxic and more effective for improving prognoses and patient outcomes:

  • Engineered monoclonal “T-cell engager” antibodies
  • T-cells modified to express chimeric (two DNA sets) antigen receptors
  • Gene-modified immune cells
  • Immune cell redirection strategies
  • Immunotoxins
  • Vaccines

References

Chronic Myeloid Leukaemia. NHS. Available from URL: https://www.nhs.uk/conditions/.

Einsele, Hermann, et al. Immune-based Therapies for Hematological Malignancies: An Update by the EHA SWG on Immunotherapy of Hematological Malignancies. HemaSphere. Available from URL: https://journals.lww.com/hemasphere/

Leukemia. Complementary and Alternative Medicine. St. Luke's Hospital. Available from URL: https://www.stlukes-stl.com/.

Nabi, Jasmine and Hohl, Raymond J. Hematologic Malignancies. https://www.sciencedirect.com/.

Non-Hodgkin Lymphoma. Leukemia and Lymphoma Society. Available from URL: https://www.lls.org/.

What Is Acute Lymphocytic Leukemia (ALL)? American Cancer Society. Available from URL: https://www.cancer.org/.

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