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What Is Blood Cancer?

By Naheed Ali, MD, PhD, ScD | November 07, 2024

Reviewed by Gwen Nichols, MD, EVP and Chief Medical Officer at The Leukemia & Lymphoma Society

Table of Contents

Blood cancer affects the blood, bone marrow, and lymphatic systems, disturbing the production and function of blood cells and platelets. These components are crucial for your body’s ability to fight infection, carry oxygen, and control bleeding (Forte et al. 2021, 416). 

If you or someone you love is affected by blood cancer, understanding the basics can help you navigate the challenges ahead. The Leukemia & Lymphoma Society (LLS) is dedicated to supporting those with blood cancers through resources, research, and advocacy. 

Types of Blood Cancer 

There are five main types of blood cancer: leukemia, lymphoma, myeloma, MPNs, and myelodysplastic syndrome. Blood cancer types can be further classified into subtypes, affecting different types of blood cells in various ways. 

Leukemia 

Leukemia is a cancer of the blood and bone marrow that results in the production of abnormal blood cells, particularly certain types of white blood cells (Dong et al. 2020, 1-11). In the United States, an estimated 456,481 people are living with leukemia (The Leukemia & Lymphoma Society 2024). These abnormal cells can hinder the body’s ability to fight infections and perform other essential functions. Let’s take a closer look at the various types of leukemia: 

  • Acute Lymphoblastic Leukemia (ALL): ALL is the most common type of leukemia found in children, although it can also occur in adults. It progresses rapidly, which means that treatment needs to start right away. In ALL, the bone marrow produces too many immature white blood cells, which crowd out healthy cells, making it difficult for the body to fight infections. 
  • Acute Myeloid Leukemia (AML): AML is a fast-growing type of leukemia that affects immature white blood cells, which are crucial for fighting infections. These abnormal cells grow uncontrollably, crowding out healthy cells in the bone marrow. Like ALL, AML progresses quickly and typically requires immediate treatment to manage the rapid spread of the disease and restore normal blood function. 
  • Chronic Lymphocytic Leukemia (CLL): CLL is more common in older adults and progresses more slowly than acute leukemias. It involves a type of white blood cell called lymphocytes, which are crucial for the immune system. In CLL, the body produces too many abnormal lymphocytes that don’t work properly, but because it progresses slowly, doctors may choose to monitor it closely before beginning treatment. 
  • Chronic Myeloid Leukemia (CML): CML affects myeloid cells and is characterized by the overproduction of more mature but abnormal cells. This type of leukemia progresses more gradually than acute leukemia, and many people with CML can live with the disease for years with a targeted treatment that helps control the growth of these abnormal cells. 
  • Hairy Cell Leukemia (HCL): HCL is a rare subtype of CLL named for the "hairy" appearance of the abnormal cells under a microscope. This type usually affects middle-aged adults and progresses slowly. Although it’s rare, there are effective treatments available that can manage the disease well. 
  • Chronic Myelomonocytic Leukemia (CMML): CMML is a type of leukemia that affects both the bone marrow and the blood, leading to the overproduction of monocytes, a type of white blood cell. This overproduction can interfere with the body’s ability to make healthy blood cells. 
  • Juvenile Myelomonocytic Leukemia (JMML): JMML is a very rare and aggressive form of leukemia that affects young children. It involves the overproduction of immature blood cells, which can cause symptoms such as fever, skin rashes, and enlarged lymph nodes or spleen. Early and aggressive treatment is often necessary. 
  • Large Granular Lymphocytic (LGL) Leukemia: LGL leukemia is a rare type of leukemia that affects large granular lymphocytes, which are specialized white blood cells that help fight infections. This leukemia typically progresses slowly. 
  • Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN): BPDCN is a very rare and aggressive type of leukemia that starts in the cells responsible for the immune response, known as dendritic cells. This type can present as skin lesions and can spread to other parts of the body, including the lymph nodes and bone marrow. 
  • B-cell Prolymphocytic Leukemia (B-PLL): B-PLL is a rare and aggressive form of leukemia that affects B-cells, a type of white blood cell involved in the immune response. It progresses rapidly and usually requires prompt treatment to control the spread of abnormal cells. 
  • T-cell Prolymphocytic Leukemia (T-PLL): Similar to B-PLL, T-PLL is a rare and aggressive leukemia affecting T-cells. This type progresses quickly and can be challenging to treat, often requiring a combination of therapies to manage the disease. 

Acute vs. Chronic Leukemia 

When learning about leukemia, it’s essential to understand the difference between acute and chronic forms: 

  • Acute leukemia: These develop rapidly, requiring immediate treatment. They involve the fast growth of immature blood cells, which crowd out healthy cells and cause your health to deteriorate quickly if not effectively treated. 
  • Chronic leukemia: These often progress more slowly. They usually involve the buildup of more mature, but still abnormal, blood cells, which can lead to a slower onset of symptoms. Chronic blood cancers may or may not need immediate treatment. 

This distinction is important because it influences how each type of cancer is managed and treated. 

Understanding your or your loved ones’ specific type of blood cancer can help you feel more prepared when discussing options with healthcare providers. Remember, while the terminology can seem overwhelming, you’re not alone—resources and support from organizations like the LLS are here to guide you through every step of the way. 

Lymphoma 

Lymphoma is a type of blood cancer that affects the lymphatic system, a crucial part of your immune system responsible for helping your body fight infections and other diseases (Lewis et al. 2021, 34-41). Unlike leukemia, which primarily affects the blood and bone marrow, lymphoma specifically targets the lymphatic system, including lymph nodes, spleen, and other lymphoid tissues. 

The lymphatic system is a vital part of your immune system, working alongside your blood circulatory system to help protect your body from infections and other diseases. It consists of a network of lymph nodes, lymph vessels, and organs such as the spleen, tonsils, and thymus, all of which work together to filter out harmful substances and produce and transport lymph—a clear fluid that contains infection-fighting white blood cells, particularly lymphocytes. 

Lymphoma is broadly classified into these types: 

  • Non-Hodgkin Lymphoma (NHL): Non-Hodgkin lymphoma (NHL) is a diverse group of blood cancers that includes many subtypes, each with its own characteristics and treatment needs. Some of the most common subtypes are diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, mantle cell lymphoma (MCL), marginal zone lymphoma (MZL), and Burkitt lymphoma. NHL is more common than Hodgkin lymphoma and can vary greatly in its behavior, ranging from slow growing (indolent) types, like follicular lymphoma and MZL, which may not require immediate treatment, to aggressive forms, such as DLBCL and Burkitt lymphoma, which need prompt treatment. 
    Understanding the specific subtype of NHL is crucial because it directly influences the treatment approach. For instance, aggressive lymphomas like DLBCL typically require intensive chemotherapy, while indolent lymphomas may be managed with a "watch and wait" approach or less aggressive treatments. Subtype identification helps healthcare providers tailor treatment plans to meet the unique needs of each patient, improving outcomes and quality of life. 
  • Hodgkin Lymphoma: This type is recognized by the presence of Reed-Sternberg cells, which are large abnormal cells that can be identified under a microscope. Hodgkin lymphoma is known for its predictable pattern of spreading and, importantly, for having treatment options that often lead to long-term remissions. This has made Hodgkin lymphoma one of the more curable forms of cancer, with a variety of effective therapies available. 
  • Waldenstrom Macroglobulinemia: Waldenstrom macroglobulinemia (WM) is a rare type of non-Hodgkin lymphoma where certain white blood cells called plasma cells start growing uncontrollably due to changes in their DNA. These abnormal cells can produce too much of a specific antibody known as immunoglobulin M (IgM). The excess IgM can cause the blood to thicken, leading to complications like vision problems, dizziness, and bleeding issues (Gertz 2023, 348-358). 

In 2024, about 89,190 people in the U.S. are expected to be diagnosed with lymphoma, including around 8,570 cases of Hodgkin lymphoma and 80,620 cases of non-Hodgkin lymphoma (The Leukemia & Lymphoma Society 2024). 

If you or someone you know is facing a lymphoma diagnosis, there are many treatment options available, and ongoing research continues to improve outcomes for patients. 

Multiple Myeloma 

Multiple myeloma is a type of blood cancer that affects plasma cells, which are a type of white blood cell responsible for producing antibodies that help fight infections. In multiple myeloma, abnormal plasma cells accumulate in the bone marrow, crowding out healthy cells and leading to various complications like bone damage, anemia, and kidney problems (Cowan et al. 2022, 464-477). Multiple myeloma involves cancerous plasma cells that don't work correctly. An estimated 168,234 people in the United States are currently living with or in remission from myeloma (The Leukemia & Lymphoma Society 2024). 

Myeloproliferative Neoplasms (MPNs) 

Myeloproliferative neoplasms (MPNs) are a group of rare blood cancers in which the bone marrow—the spongy tissue inside your bones that produces blood cells—begins to produce too many blood cells. 

The symptoms and complications can vary widely depending on which type of blood cell is being overproduced. This can lead to various complications, such as blood clots, bleeding issues, and an increased risk of other conditions, including fibrosis (scarring) of the bone marrow and, in some cases, progression to acute leukemia (Greenfield et al. 2021, 1-18). It’s estimated that about 120,761 people in the United States are living with or in remission from MPNs (The Leukemia & Lymphoma Society 2024). 

Here’s a closer look at the main types of MPNs: 

  • Essential Thrombocythemia (ET): This condition causes the body to produce too many platelets, the cells responsible for blood clotting. Having too many platelets can lead to dangerous blood clots or to bleeding problems if the platelets are abnormal. 
  • Myelofibrosis: Myelofibrosis is a more serious form of MPN where scar tissue forms in the bone marrow, disrupting its ability to produce blood cells. This can lead to severe anemia (a shortage of red blood cells), fatigue, and an enlarged spleen as the body tries to compensate for the dysfunctional marrow. 
  • Polycythemia Vera (PV): PV leads to the overproduction of red blood cells, which can make the blood thicker and increase the risk of blood clots. Symptoms might include headaches, dizziness, and a reddish complexion. 

Myelodysplastic Syndromes (MDS) 

Myelodysplastic syndromes (MDS) are a group of blood cancers caused by poorly formed or dysfunctional blood cells. This results from the bone marrow’s inability to produce enough healthy blood cells, leading to symptoms such as severe anemia, frequent infections, and bleeding issues (Sekeres and Taylor 2022, 872-880). MDS can be thought of as a precursor to leukemia, as it often involves immature blood cells that can progress to acute myeloid leukemia. An estimated 60,041 people in the United States are living with or in remission from MDS (The Leukemia & Lymphoma Society 2024). 

Each of these cancers has unique challenges and treatment needs, but understanding them can empower you to take an active role in managing your health or supporting someone who is facing these diagnoses. 

What Causes Blood Cancer? 

Most blood cancers do not have a specific cause that can be determined. It is thought that blood cancer begins when a mutation occurs in the DNA of blood cells, leading to the uncontrolled growth and accumulation of blood cells. While the exact cause of these mutations isn’t always clear, several factors can increase the risk of developing blood cancer. These include genetic predispositions, family history of blood cancers, exposure to radiation, and contact with certain hazardous chemicals. For example, exposure to Agent Orange, benzene, and other industrial chemicals (such as pesticides, herbicides, formaldehyde, toluene, and arsenic) has been linked to an increased risk of blood cancers (Howell et al. 2022). Most patients who develop blood cancers have no specific exposure that can be determined. 

Here’s a closer look at some factors associated with specific types of blood cancer: 

  • Leukemia and Myeloma: These types may be linked to genetic factors, previous cancer treatments, or exposure to high levels of radiation and chemicals like benzene. 
  • Lymphoma: Factors include a weakened immune system, presence of rheumatologic illnesses (such as Sjögren's syndrome), certain viral infections (such as Epstein-Barr virus), and possibly exposure to pesticides or herbicides. 
  • Myeloproliferative Neoplasms: This may be related to genetic mutations, such as changes in the JAK2 gene, which can affect blood cell production. 
  • Myelodysplastic Syndromes: MDS can be associated with genetic abnormalities, previous chemotherapy or radiation therapy, and exposure to certain chemicals, such as benzene and heavy metals, which can damage the DNA of blood cells. 

Reducing exposure to known risk factors—such as avoiding tobacco, limiting contact with harmful chemicals, and maintaining a healthy lifestyle—can help lower your risk. 

Symptoms of Blood Cancer 

Blood cancer can cause a wide range of symptoms, which vary depending on the type and stage of the disease. Some common signs and symptoms include: 

  • Persistent fever or chills 
  • Long-lasting fatigue and weakness 
  • Unexplained weight loss 
  • Night sweats 
  • Bone or joint pain 
  • Abdominal discomfort or swelling 
  • Frequent infections 
  • Shortness of breath 
  • Itchy skin or rash 
  • Swollen lymph nodes in the neck, underarms, or groin 
  • Unexplained bruising 

It's important to remember that these symptoms are not exclusive to blood cancer and can be indicative of many other conditions. This can make blood cancers challenging to diagnose. Many individuals with blood cancer report that their symptoms were initially mistaken for other common illnesses. 

If you are experiencing these symptoms and feel that something isn’t right, it’s essential to advocate for yourself and seek a medical evaluation. Trust your instincts, and don’t hesitate to ask for a second opinion if needed. Remember, you're not alone—support is available, and resources like The Leukemia & Lymphoma Society can help guide you. 

Blood Cancer Diagnosis 

Diagnosing blood cancers typically involves a series of tests and procedures to understand the type and extent of the disease. The process often starts with blood tests, which measure the levels of different blood cells and can reveal abnormalities that suggest blood cancer. If blood tests indicate a potential issue, a bone marrow biopsy might be performed. This involves taking a small sample of bone marrow, usually from the hip bone, to check for cancerous changes directly in the blood-forming tissues. 

Imaging scans such as CT scans or MRIs are also commonly used. These scans help doctors see if the cancer has spread to other parts of the body, such as the lymph nodes, spleen, or other organs (Shadman 2023, 918-932). It’s understandable that this process can feel daunting, but each test provides crucial information that guides the next steps in individualized care. 

Blood Cancer Treatment 

The treatments for blood cancer depend on the specific type, stage of the disease, and individual patient factors. Decades of LLS research funding has played a major role in the wide range of treatments available today. Here’s an overview of the main blood cancer therapy options, when they are typically used, and what they aim to achieve: 

  • Chemotherapy: This treatment uses powerful drugs to kill cancer cells or stop them from growing and dividing. Chemotherapy can be used alone or in combination with other treatments and has been a mainstay for many types of blood cancers, including leukemias and lymphomas. It can be given in cycles, allowing periods of recovery between treatments (Wendtner and Gregor 2018, 300-310). 
  • Targeted Therapy: Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapy works by specifically attacking cancer cells based on their unique characteristics. This approach causes less damage to normal cells and is often used for cancers with specific genetic mutations or abnormalities, such as chronic myeloid leukemia (CML) or certain types of lymphoma (Cucchi et al. 2021, 651-660). 
  • Immunotherapy: This treatment, like CAR-T, helps boost your own immune system’s ability to fight cancer. It can be particularly effective for certain types of lymphomas and leukemias. Immunotherapy drugs can help the immune system recognize and destroy cancer cells more effectively (Vago and Gojo 2020, 1552-1564). 
  • Radiation Therapy: Radiation therapy uses high-energy radiation to target and destroy cancer cells. It may be used for lymphomas or to target specific areas of bone where myeloma cells have caused damage. Radiation can also be used to shrink enlarged lymph nodes or relieve symptoms such as pain (Ng et al. 2018, 652-669). 
  • Stem Cell Transplant: This procedure is used to replace damaged or destroyed bone marrow with healthy stem cells, which can help the body produce new, healthy blood cells (Wu 2024). There are different types of stem cell transplants: 
    • Autologous Transplant: Uses the patient’s own stem cells, collected before high-dose chemotherapy or radiation. This approach may be used for multiple myeloma or certain types of lymphoma. 
    • Allogeneic Transplant: Uses stem cells from a donor whose tissue type closely matches the patient. This is commonly used for certain leukemias and can provide a new, healthy immune system that may also attack any remaining cancer cells. This approach may be used for leukemia, myelodysplastic syndromes, and myeloproliferative neoplasms. 
    • Reduced-intensity Transplant: Also known as a mini-transplant, this is a type of stem cell transplant that uses milder doses of chemotherapy or radiation before the procedure. It’s designed for patients who might not be strong enough for the usual high-dose treatment, like older adults or those with other health issues. The idea is to still let the donor’s healthy cells take over and help fight the cancer, but with fewer side effects and risks than a standard transplant. 

Each of these treatments can have various side effects, including fatigue, nausea, and an increased risk of infections due to their impact on the immune system. It’s important to have open conversations with your healthcare provider about what to expect and how to manage these side effects. 

Recent advancements in precision medicine, like LLS’s Beat AML® Master Clinical Trial, have enabled doctors to use genomic analysis to better understand the specific characteristics of a patient’s cancer. This approach allows for more personalized and targeted treatment plans, tailored to the unique genetic makeup of each individual’s AML. 

Blood Cancer Prognosis and Survival Rate 

Over the past few decades, there has been remarkable progress in the survival rates and quality of life for people who have blood cancer, largely due to advances in treatment, early diagnosis, and personalized care (The Leukemia & Lymphoma Society 2024). This progress offers hope and highlights the importance of ongoing research and support in treating blood cancer. 

For many types of leukemia, blood cancer survival rates have significantly improved. For instance, children diagnosed with acute lymphoblastic leukemia (ALL) have a very encouraging outlook, with over 92% of those younger than 15 years surviving at least five years after diagnosis. Chronic lymphocytic leukemia (CLL) also boasts a strong survival rate, with many patients living well beyond five years due to the success of targeted therapies that enhance both longevity and quality of life. Chronic myeloid leukemia (CML) has seen some of the most remarkable progress; once considered fatal within five years, it is now a condition where patients can often live out their normal lifespan, thanks to effective targeted therapies. These advancements highlight the power of ongoing research and personalized treatment in transforming outcomes for those with blood cancers. 

Hodgkin lymphoma stands out as one of the most treatable forms of cancer, with many patients achieving long-term remission. The five-year survival rate for Hodgkin lymphoma is about 92%, and it’s even higher—nearly 96%—for those diagnosed before the age of 50. Non-Hodgkin lymphoma has also seen significant strides, with treatments continually evolving to offer more options and hope for those affected. 

Multiple myeloma, a cancer that primarily affects older adults, has seen its five-year survival rate improve significantly, reflecting the impact of new therapies and treatment combinations that are helping people live longer and better lives. 

These advancements remind us that every patient’s journey is unique, and while statistics can provide a general outlook, they don’t define individual experiences. With early detection, personalized treatment plans, and a strong support system, there is more reason than ever to feel hopeful. Remember, these numbers are a testament to the incredible progress made and the continued efforts to improve outcomes for everyone facing blood cancer. Stay connected with your healthcare team, lean on your support network, and know that there are always new avenues of hope and care being developed. 

Supporting Those Diagnosed with Blood Cancer 

Supporting someone diagnosed with blood cancer involves providing emotional, practical, and medical assistance. Emotional support includes being a compassionate listener and offering encouragement. Practical support might involve helping with daily tasks or accompanying them to medical appointments. Staying informed about the disease, its treatment options, and survival rates can also help you better assist your loved one through their journey. 

LLS offers a variety of patient services designed to help navigate the complexities of blood cancer treatment and care. One of these resources is the Information Resource Center (IRC), established in 1997, where patients, caregivers, and healthcare professionals can speak one-on-one with highly trained blood cancer Information Specialists. These specialists are oncology social workers and nurses who provide accurate, current information about disease management, treatment options, financial challenges, and social support, helping patients make informed decisions about their care. 

Finding a clinical trial can be overwhelming, but LLS's Clinical Trial Support Center (CTSC) offers a free service that takes this burden off patients and families. By working one-on-one with an LLS Clinical Trial Nurse Navigator—registered nurses with expertise in pediatric and adult blood cancers—patients receive personalized assistance throughout the entire clinical trial process. These Nurse Navigators help identify clinical trial options tailored to each patient’s specific cancer and situation, providing clarity and support every step of the way. 

LLS also recognizes the importance of nutrition in cancer care. Through the Nutrition Education Services Center, patients and caregivers of all cancer types can receive free one-on-one consultations with registered dietitians who specialize in oncology nutrition. These dietitians offer personalized guidance and education, helping patients manage their nutritional needs during treatment. 

Caregivers play a vital role in supporting those diagnosed with blood cancer, and it’s important that they receive support too. LLS offers a variety of resources specifically for caregivers, including the opportunity to speak one-on-one with an Information Specialist for guidance on navigating the challenges of caregiving. LLS also provides a comprehensive Caregiver Workbook to help organize medical information, and communication resources to assist with managing conversations and maintaining emotional well-being. These tools ensure that caregivers have the support they need throughout their loved one’s experience. 

Beyond these personalized services, LLS provides a wealth of resources, including educational materials, webinars, and support groups, all accessible through our patient support page. 

LLS Blood Cancer Research and Policy Impact 

The Leukemia & Lymphoma Society (LLS) has been instrumental in driving progress in blood cancer research and treatment. Since 1949, LLS has invested over $1.7 billion in cancer research, supporting groundbreaking studies that have paved the way for new therapies. Notably, LLS has played a key role in advancing 70% of the blood cancer treatment options approved by the FDA since 2017, highlighting its significant impact on improving survival rates and patient outcomes. But LLS’s impact goes beyond research; it’s also about providing comprehensive support and resources to patients and their families every step of the way. 

LLS’s Office of Public Policy (OPP) is dedicated to advocating for policies that safely accelerate the development of new treatments and break down barriers to care for blood cancer patients. OPP works to ensure that patients have access to quality, affordable care, no matter where they are in their treatment. You can get involved by signing up to become an advocate, where you can share your voice and help influence policymakers. Through the Mobile Action Network, you can stay informed about the latest policy issues and easily take action. By sharing your personal story, you can help create real change for blood cancer patients. 

By supporting LLS, you are making a meaningful impact in the fight against blood cancer. Your contributions help fund groundbreaking research, provide crucial resources and support services for patients and families, and advocate for policies that improve access to care. Consider donating to LLS to support these vital efforts and bring hope to those affected by blood cancer. 

Conclusion 

Navigating a blood cancer diagnosis can be overwhelming, but you don’t have to face it alone. Blood cancer is a complex disease, but with the right information and a strong support system, you can take empowered steps forward. Organizations like the LLS are here to walk alongside you, offering resources, guidance, and a community that understands what you’re going through. From funding life-saving research to providing patient support and advocacy, LLS is dedicated to helping individuals and families at every step of their journey. 

Remember, staying informed and connected with trusted support networks can make a big difference. Lean on your healthcare team, reach out to support groups, and don’t hesitate to ask questions or seek a second opinion. You are your best advocate, and there are many people and resources ready to support you. Together, we can navigate the challenges of blood cancer with hope, strength, and resilience. 

About the author: Dr. Ali is a medical journalist and copywriter. 

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