Blood cancer is a concern in the US

The new figures released by the Leukemia & Lymphoma Society are at least troubling, as nearly 10% of new cancer diagnoses are blood cancers in the US.

September is Blood Cancer (Blood Malignancies) Awareness Month and serves as an important time to draw attention to a group of cancers that affect the blood, bone marrow and lymphatic system.

Hematologic malignancies, including leukemia, lymphoma, and multiple myeloma, affect millions of people worldwide, and yet, are often left out of the broader cancer conversation.

This month is an opportunity to raise awareness, to support patients and their relatives and to highlight the need for more research and resources for the development of new treatments, as stated by Thanos Dimopoulos (retd. Rector EKPA, Professor of Therapeutics – Oncology – Hematology , Director of the Therapeutic Clinic of the Faculty of Medicine of the EKPA, Alexandra Hospital) and lists some facts.

Blood cancer is a term that includes several types of cancer that affect the white blood cells, bone marrow, and lymphatic system. The most common types are leukemia, lymphoma, and multiple myeloma. Each of these cancers behaves differently and requires different treatment approaches:

Leukemia affects the bone marrow and blood, leading to the production of abnormal white blood cells that interfere with the body’s ability to fight infection. Leukemia can be acute (acute lymphoblastic leukemia, acute myeloid leukemia) or chronic (chronic lymphocytic leukemia, chronic myeloid leukemia), while there are also rarer manifestations of the disease such as chronic myelomonocytic leukemia, hairy cell leukemia and others. The treatment approach is individualized according to the subtype of leukemia and may include a combination of chemotherapy agents and immunotherapy. It is worth noting that in some types of leukemia, such as acute lymphoblastic leukemia, which is resistant to previous treatments, treatment with T-lymphocytes carrying a chimeric antigen receptor (CAR T-lymphocytes) has been approved with a significant improvement in life expectancy and quality of life of patients.

Lymphoma starts in the lymphatic system, which is a critical part of the immune system. It causes abnormal growth of lymphocytes, a type of white blood cell, and can spread to different parts of the body. There are many different types and subtypes of lymphoma depending on whether they are aggressive or indolent and whether they originate from B or T cells. Newer CAR T-cell and bispecific antibody immunotherapies have significantly improved outcomes for patients with relapsed/refractory lymphoma.

For example, epcoritamab results in deep and sustained responses in patients with relapsed or refractory large B-cell lymphoma (DLBCL), who have received 2 or more lines of therapy with manageable toxicity. mosunetuzumab is now a treatment option for patients with relapsed or refractory nodular lymphoma after at least 2 prior lines of therapy.

The next-generation BTK inhibitor, pirtobrutinib, has shown efficacy and is now also an option for patients with mantle cell lymphoma and refractory/relapsed disease. In Hodgkin’s lymphoma, in recent years, the classical regimen of AVD (without bleomycin) in combination with brentuximab vedotin, a drug-conjugated monoclonal antibody, has joined the treatment in the first line of treatment, while the nivolumab-AVD combination appears to be superior and is likely to will soon be the first treatment option for these patients.

Multiple myeloma starts in plasma cells, another type of white blood cell found in the bone marrow, disrupting normal antibody production and making the body more vulnerable to infections. Today, the vast majority of patients respond to initial treatment and many patients remain in remission for a long time. But several times, malignant myeloma cells become resistant to treatment over time and the disease recurs.

Relapsed and/or refractory multiple myeloma after multiple lines of therapy is a real challenge for clinicians. Newer immunotherapies such as T-lymphocytes carrying chimeric antigen receptor (CAR) and bispecific antibodies have joined the therapeutic arsenal and improve the prognosis and quality of life of patients. These drugs are also being evaluated in clinical trials with the aim of giving them earlier and optimizing long-term remission rates after first-line therapy.

Awareness of hematological malignancies is vital for several reasons.

First, blood cancers often present with vague or nonspecific symptoms such as fatigue, fever, night sweats, unexplained weight loss, or swollen lymph nodes. These symptoms can easily be mistaken for other, less serious conditions, leading to delayed diagnosis and treatment. Increasing awareness can encourage people to seek medical advice earlier, possibly detecting the disease in its early stages when it is potentially treatable.

Second, blood cancers remain an important public health issue. According to the Leukemia & Lymphoma Society, blood cancers account for nearly 10% of all new cancer diagnoses each year in the United States. Globally, millions of people live with these cancers, but the funding and resources devoted to blood cancer research fall short of those available for better-known cancers such as breast or lung cancer.

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