Haematological Malignancies

There are several types of haematological malignancies, a few that we specialise in are:

• Leukemia
• Lymphoma
• Plasma Cell Disorders
• Myeloproliferative Disorders

LEUKEMIA

Leukemia is a type of cancer that affects the body’s ability to make healthy blood cells. It starts in the bone marrow, which is where new blood cells are made. Blood cells include:

• Red blood cells – carry oxygen from the lungs to the body’s tissues and take carbon dioxide to the lungs to be exhaled
• Platelets – help blood to clot
• White blood cells – help fight infections, viruses, and diseases.

Although cancer is known to affect red blood cells and platelets, leukemia generally refers to cancer of the white blood cells. The disease often affects one of the two major types of white blood cells: lymphocytes and granulocytes. These cells circulate throughout the body to help the immune system fight off viruses, infections, and other invading organisms. Leukemias arising from lymphocytes are called lymphocytic leukemias; those from granulocytes are called myeloid, or myelogenous, leukemias.

Leukemia is either acute (comes on quickly) or chronic (spans a long time). The type of leukemic cell determines whether it is an acute leukemia or chronic leukemia. Chronic leukemia rarely affects children; acute leukemia affects adults and children.

ACUTE LEUKEMIAS

With acute leukemia, immature white blood cells multiply quickly in the bone marrow. Over time, they overcrowd healthy cells. (Patients may notice that they bleed a lot or suffer from infections as a result.) When these cells reach high numbers, sometimes they spread to other organs, causing internal damage. This is especially true in acute myeloid leukemia. The two main types of acute leukemia involve different types of blood cells:

• Acute lymphocytic leukemia (ALL) is the most common type of leukemia in children, mainly affecting those under age 10. Adults sometimes develop ALL, but it is rare in people older than 50.
• Acute myeloid leukemia (AML) accounts for half of leukemia cases diagnosed in teenagers and in people in their 20s. It is the most common acute leukemia in adults.

Both ALL and AML have multiple subtypes. The treatment we offer and prognosis may vary somewhat, depending on the subtype. You can be sure we consider all factors before determining a treatment type.

CHRONIC LEUKEMIAS

Chronic leukemia is when the body produces too many blood cells that are only partially developed. These cells often cannot function like mature blood cells. Chronic leukemia usually develops more slowly than acute leukemia. There are two main types of chronic leukemia:

• Chronic lymphocytic leukemia (CLL) is rare in people under age 30. It is more likely to develop as a person ages. Most cases occur in people between ages 60 and 70. In CLL, abnormal lymphocytes cannot fight infection as well as normal cells can.
• Chronic myeloid leukemia (CML) occurs most often in people between ages 25 and 60. In CML, the abnormal cells are a type of blood cell called myeloid cells. CML usually involves a defective string of DNA called the Philadelphia chromosome.

Both CLL and CML have subtypes. They may also share characteristics with other forms of leukemia. You can be sure we consider all factors and perform detailed diagnosis before determining a treatment type.

LYMPHOMAS

Lymphoma affects the blood and the lymphatic system—part of your body’s germ-fighting setup that includes lymph nodes (like the ones in your neck that get swollen when you have a bad cold), the spleen, bone marrow, and an immune gland in the chest called the thymus.

Lymphoma starts when white blood cells in your body called lymphocytes mutate and start to grow out of control. White blood cells are known as the ‘infection fighters’, these mutations affect your body’s immune system and ability to recover.

There are more than 70 different “subtypes” of lymphoma, but all of them fall under two main categories: Hodgkin’s lymphoma—which used to be called “Hodgkin’s disease” after Thomas Hodgkin, the doctor who first described it in 1832—and non-Hodgkin lymphoma.

We treat all lymphomas, some of these are listed below:

HODGKINS LYMPHOMAS

Hodgkins disease, also known as Hodgkins Lymphomas  is a type of cancer that affects part of the immune system known as the lymphatic system.

NON-HODGKINS LYMPHOMAS

B-CELL LYMPHOMAS

• Diffuse large B-cell lymphomas
• Primary mediastinal B-cell lymphoma
• Follicular lymphoma
• Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL)
• Mantle cell lymphoma
• Marginal zone lymphomas
• Extranodal marginal zone B-cell lymphoma
• Nodal marginal zone B-cell lymphoma
• Splenic marginal zone B-cell lymphoma
• Burkitt lymphoma
• Lymphoplasmacytic lymphoma
• Hairy cell leukemia
• HIV/AIDS associated lymphomas
• Post-transplant lymphoproliferative disease (PTLD)
• Cutaneous B-cell lymphomas

T-CELL LYMPHOMAS

• Peripheral T-cell lymphomas
• Peripheral T-cell lymphoma, unspecified
• Angioimmunoblastic T-cell lymphoma
• Enteropathy-associated type T-cell lymphoma
• Subcutaneous panniculitis-like T-cell lymphoma
• Anaplastic large cell lymphoma
• Extranodal NK/T-cell lymphoma, nasal type
• Acute T-cell leukemia/lymphoma (HTLV-associated)
• Hepatosplenic T-cell lymphoma
• Large granular lymphocyte leukemia
• T-cell prolymphocytic leukemia
• Cutaneous T-cell lymphomas

PLASMA CELL DISORDERS

Myeloma and AL Amyloidosis are diseases of the plasma cell. Plasma cells produce immunoglobulins, there are antibodies that assist in fighting infections and supporting immune systems. Plasma cell diseases are a type of blood cancer in which plasma cells become malignant and can cause damage to the bones, kidneys, heart, bone marrow and immune system, and as a result can make patients unwell. Plasma cell diseases include multiple myeloma, systemic light-chain (AL) amyloidosis, and monoclonal immunoglobulin deposition disease.

MYELOPROLIFERATIVE DISORDERS

Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets. This overproduction of blood cells in the bone marrow can create problems for blood flow and lead to various symptoms. MPNs were called Myeloproliferative Diseases until 2008 when the World Health Organization reclassified them as cancers and renamed them Myeloproliferative Neoplasms.

There are several types of MPNs, these are some of the more common ones:

• Polycythemia vera (PV)
• Essential thrombocythemia (ET)
• Myelofibrosis (MF)
• Chronic Myeloid Lymphoma (CML)