Although
hematological malignancies are a form of
cancer, they are generally treated by specialists in
hematology, although in many hospitals
oncology specialists also manage these diseases.
Definition
Hematological malignancies are the types of
cancer that affect
blood,
bone marrow and
lymph nodes. As the three are intimately connected through the
immune system, a disease affecting one of the three will often affect the others as well: although
lymphoma is technically a disease of the
lymph nodes, it often spreads to the
bone marrow, affecting the
blood and occasionally producing a
paraprotein.
Chromosomal translocations are a common cause of these diseases, while this is uncommon in solid tumors. This leads to a different approach in diagnosis and treatment of hematological malignancies.
List of diseases
The
hematological malignancies include:
Related disorders, which are generally not called "cancer":
Diagnosis
For the analysis of a suspected
hematological malignancy, a full blood count and
blood film are essential, as malignant cells can show in characteristic ways on light microscopy. When there is
lymphadenopathy, a
biopsy from a
lymph node is generally undertaken
surgically. In general, a
bone marrow biopsy is part of the "work up" for the analysis of these diseases. All specimens are examined microscopically to determine the nature of the malignancy. A number of these diseases can now be classified by
cytogenetics (AML, CML) or
immunophenotyping (lymphoma, myeloma, CLL) of the malignant cells.
Treatment
Treatment can occasionally consist of "watchful waiting" (e.g. in
CLL) or symptomatic treatment (e.g.
blood transfusions in
MDS). The more aggressive forms of disease require treatment with
chemotherapy, radiotherapy,
immunotherapy and - in some cases - a
bone marrow transplant.
Follow-up
If treatment has been successful ("complete" or "partial remission"), a patient is generally followed up at regular intervals to detect recurrence and monitor for "secondary malignancy" (an uncommon side-effect of some
chemotherapy and radiotherapy regimens - the appearance of another form of
cancer).
Category:Hematology
Category:Oncology
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