Leukemia
Lymphoma
Myeloma
Blood Diseases, Disorders & Syndromes
LEUKEMIA
Leukemia is a broad term for cancers of the blood cells. It starts in blood-forming tissue, such as your bone marrow, and causes large numbers of abnormal blood cells to be produced and enter your bloodstream. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. At Stony Brook Cancer Center, we treat all type sof blood cancers, including the four primary types of leukemia.
Acute Lymphocytic Leukemia (ALL)
ALL is an aggressive (fast-growing) cancer of the blood and bone marrow that affects white blood cells. While people of all ages develop ALL, a majority of new diagnoses are in people under age 20. It is the most common childhood cancer. It occurs when a bone marrow cell develops errors in its DNA. Symptoms may include enlarged lymph nodes, bruising, fever, bone pain, bleeding from the gums and frequent infections.
Acute Myelogenous Leukemia (also know as: Acute Myeloid Leukemia (AML))
AML is the most common acute leukemia in adults. While pediatric patients can develop the disease, most diagnoses are in people over age 55. The median age of diagnosis is 68. As an acute leukemia, AML is aggressive and can be particularly difficult to treat. AML occurs when a myeloid stem cell becomes cancerous. In these cases, the myeloid stem cells produce diseased cells. These cells don’t do their job well and multiply so rapidly that they crowd out healthy cells. AML can severely weaken the patient’s immune system, leading to frequent infections. Most of these AML subtypes are based on how the diseased cells differ from healthy cells and how far along they are in the development process. Specific chromosome abnormalities in the cancer cells and the disease’s own genetic mutations also impact the prognosis.
Chronic Leukemia: (also know as: Chronic Lymphocytic Leukemia (CLL))
Chronic lymphocytic leukemia (CLL) is the most common chronic leukemia in adults. The average age at diagnosis is 72. The disease is twice as common in men as women. It is less aggressive than acute forms of leukemia. CLL develops from B cells. These start out as lymphoid stem cells, then mature into adult B cells. In CLL, a cancerous B cell grows and multiplies in the bone marrow, lymph nodes, liver and spleen and results in a high white blood cell count. These cancerous cells are not able to fight infection. They also crowd out healthy cells from the marrow, and cause enlargement of the lymph nodes, liver and spleen.
Chronic Myelogenous Leukemia: (also know as: Chronic Myeloid Leukemia (CML))
Chronic myeloid leukemia (CML) primarily affects adults. About 68 percent of new cases are in people 55 or older, while the average age of diagnosis is 65. CML involves myeloid stem cells. When healthy, these cells form neutrophils, a type of mature white blood cell. In CML, the myeloid stem cells become cancerous. The myeloid stem cells may not fully mature and are poor at doing their jobs. They can eventually crowd healthy blood cells out of the bone marrow and cause a high white blood cell count and an enlarged spleen. As a chronic disease, CML is relatively slow to develop.
LYMPHOMA
We treat both Hodgkin and non-Hodgkin lymphoma, as well as rare forms of the disease.
Non-Hodgkin lymphoma (NHL) is the most common type of lymphoma. While it can occur at any age, most people who develop the illness are older adults. There many types of NHL, all of which are divided into two major groups: B cell lymphoma and T cell lymphoma.
- Types of B cell lymphoma account for about 80 percent of all NHL cases. It includes diffuse large B-cell lymphoma, primary mediastinal B cell lymphoma, follicular lymphoma, small lymphocytic lymphoma and chronic lymphocytic leukemia, marginal zone lymphoma, mantle cell lymphoma, Waldenström’s macroglobulinemia and Burkitt lymphoma.
- Types of T cell lymphoma account for approximately 15 percent of all cases of NHL in the United States. The most common types of T cell lymphoma include peripheral T cell lymphoma not otherwise specified, anaplastic large cell lymphoma, angioimmunoblastic lymphoma and cutaneous T cell lymphoma. There are also several types of relatively rare T cell non-Hodgkin lymphoma.
Hodgkin's Disease
Hodgkin lymphoma (Hodgkin’s disease) is an uncommon form of lymphoma. It is distinguished by the presence of large abnormal tumor cells called Hodgkin Reed-Sternberg cells. Although Hodgkin lymphoma can occur in both children and adults, it is usually diagnosed in young adults between 20 and 34. Hodgkin lymphoma has two main subtypes: classical Hodgkin lymphoma and nodular lymphocyte predominant Hodgkin lymphoma. More than 90 percent of Hodgkin lymphoma patients have classical Hodgkin lymphoma.
MULTIPLE MYELOMA
Myeloma is a cancer that arises from a type of white blood cell called a plasma cell. Plasma cells originate in the bone marrow and play an important role in your immune system. Multiple myeloma develops when a normal plasma cell changes into a myeloma cell. These are cancerous cells that can multiply uncontrollably. A normal plasma cell becomes cancerous because of changes in the bone marrow or changes in a cell’s DNA (genetic mutations).
If you have multiple myeloma, you can develop tumors in more than one location in the bone marrow and sometimes outside the bone marrow. That is why the disease is called multiple myeloma. As myeloma cells take over space in the bones where bone marrow grows, they prevent the marrow from producing essential blood cells. This includes red blood cells, which carry oxygen and other types of white blood cells, which fight infection.
BLOOD DISEASES, DISORDER & SYNDROMES
Amyloidosis
This is a group of diseases in which protein builds up in certain organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause), secondary (caused by another disease, including some types of cancer, such as multiple myeloma), or hereditary (passed down from parents to children). Many organs are affected by amyloidosis; which ones depends on whether the amyloidosis is the primary, secondary, or hereditary form.
Aplastic Anemia
Aplastic anemia is a rare but serious blood disorder that occurs when your bone marrow cannot make enough new blood cells for your body to work normally. It is also known as Bone Marrow Failure. It occurs because of damage to stem cells inside bone marrow, which is the sponge-like tissue within your bones. Many diseases and conditions can damage the stem cells in bone marrow. As a result, the bone marrow makes fewer red blood cells, white blood cells, and platelets. The most common cause of bone marrow damage is from your immune system attacking and destroying the stem cells in your bone marrow, which is a kind of autoimmune disorder.
Inherited Hemoglobin Disorders
Sickle cell disease (SCD)
SCD is an inherited disorder caused by an abnormal form of a protein called beta-globin. This can cause red blood cells to become sickle (crescent)-shaped and inflexible. Because of their abnormal shape, red blood cells have problems carrying oxygen and traveling through blood vessels. As a result, certain tissues in a child’s body don’t receive enough blood. This can cause serious problems, including severe pain, stroke or bacterial infections. If you have SCD, you may have pain in your hands, arms, legs and other parts of your body; chest pain with breathing problems; nervous system problems, from minor ones to stroke; and an enlarged spleen.
Thalassemia
This is another inherited blood disorder caused by a defect in the gene that helps control the production of hemoglobin. There are two main types of thalassemia: alpha and beta, which differ according to which protein is altered. In both cases, people with thalassemia have fewer healthy red blood cells. Children with thalassemia develop anemia and may have symptoms such as pale skin and fatigue. They may also have weakness and enlargement of organs such as the heart, spleen and liver.
Inherited Immune System Disorders
Inborn errors of metabolism are a diverse group of disorders caused by an inherited deficiency or defect in a single enzyme or protein. Your body needs these vital enzymes and proteins. When there are not enough of them, the body cannot break down certain large molecules correctly. As a result, a harmful amount of these large molecules, or “storage materials,” builds up and damages organs and body systems. If you have inborn errors of metabolism you often develop nerve deterioration. These disorders may also impair your heart, vision, hearing, bone growth, lungs and muscles. Children with these disorders may need multiple surgeries and restricted activities. They may also have growth problems and persistent discomfort. These inherited immune system disorders include:
X-Linked Adrenoleukodystrophy (X-ALD) is a rare genetic disorder that only affects males. The genetic defect impairs your body’s ability to break down certain fats, causing them to build up in your body. This affects how your adrenal glands, testes and central nervous system work. The myelin sheath — the layer of insulation that protects nerves in the body — breaks down, causing nerve cells to lose their ability to work. About 40 percent of boys with ALD experience this disorder in the brain, called cerebral ALD (cALD). Early signs of the problems include hyperactivity, poor school performance and a short attention span.
Leukodystrophies are a group of rare, progressive, metabolic, genetic diseases that affect your brain, spinal cord and often the peripheral nerves. Each type of leukodystrophy is caused by a specific gene abnormality that leads to abnormal development or destruction of the white matter (myelin sheath) of your brain. The myelin sheath is the protective covering of the nerve and nerves can't function normally without it. Each type of leukodystrophy affects a different part of the myelin sheath, leading to a range of neurological problems.
Metachromatic Leukodystrophy (MLD) is a rare inherited disorder in which a missing enzyme leads to a buildup of a fat called sulfatide in the body. The myelin sheath — the layer of insulation that protects nerves — breaks down, causing nerve cells to lose their ability to work. Children who develop MLD between the ages of 6 months and 2 years have what is called late infantile MLD. They may show a change in gross motor skills, such as walking. They may also lose their ability to speak, move, or swallow. Children with juvenile MLD begin to show symptoms between ages 4 and 12 — such as problems walking or standing up straight, emotional difficulties, trouble following directions, and poorer school performance. Adult MLD arises as early as the teen years and may be misdiagnosed as a mental health issue because the person may develop personality changes, anxiety, and an impaired memory.
Mucopolysaccharidosis Type 1 (MPS-1) is also known as Hurler syndrome and is the most severe form of MPS-1. It occurs when an enzyme needed to break down certain long chains of sugar molecules is missing. The sugars build up in many tissues in the body, which causes life-threatening organ damage. Most children with Hurler syndrome begin to show symptoms between the ages of one and 2, such as frequent colds and ear infections; noisy breathing; changes in bone growth and facial features; vision and hearing problems; and issues affecting the heart, liver and spleen. Treatment with a stem cell transplant early in life is the only way to stop the disease from progressing. A donor’s healthy cells provide a continual supply of the missing normal enzyme, halting organ damage.
Myelodysplastic Syndromes
MDSs are a group of closely related disorders that arise in the bone marrow. They occur due to a disorder of the hematopoietic stem cells. These are the immature cells from which all blood cells develop. As a result of MDS, the bone marrow makes fewer red blood cells (which carry oxygen), white blood cells (which fight infection), or platelets (which prevent or stop bleeding), or any combination of the three. In MDS, the cells in the blood and bone marrow also usually look abnormal. “Myelo” refers to the cells in the blood and bone marrow. “Dysplastic” means abnormal. This is where the name myelodysplastic syndrome comes from. The most common age at diagnosis is about 70, although people of any age can develop the disease.
Myeloproliferative Disorders
Normally, the bone marrow makes blood stem cells. These immature cells become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. A myeloid stem cell develops into one of three types of mature blood cells: a red blood cell, white blood cell, or platelet. A lymphoid stem cell becomes a white blood cell. Myeloproliferative neoplasms (MPN) occur when the bone marrow, the spongy tissue inside the large bones in the body, makes too many blood cells. These disorders are sorted based on which type of blood cell is overproduced: red blood cells, white blood cells, or platelets. Sometimes the body will make too many of more than one type of blood cell, but usually one type is affected more than the others. There are several kinds of myeloproliferative neoplasms. These include polycythemia vera, myelofibrosis, essential thrombocythemia and eosinophilia.