Blood Cancer is the cancer of Blood, Bone Marrow & Lymphatic System. Normally, blood is produced in bone marrow by a process called hematopoiesis. In our body there is a special type of cell called stem cell, which can proliferate into different kinds of blood cells (i.e. Red blood cells, white blood cells & platelets). All these blood cells have their own functions. Red blood cells carry oxygen to different part of our body, white blood cells helps in immune system and fight against infections, and platelets help to stop bleeding. But in blood cancer, there is proliferation of cancer cells which inhibits the production and function of the blood cells, as a result sign and symptoms of the disease is seen.
Usually there are three main types of Blood Cancer:
- LEUKEMIA (Acute Lymphoblastic Leukemia(ALL), Acute Myeloid Leukemia(AML), Chronic Myeloid Leukemia (CML) & Chronic Lymphoblastic Leukemia (CLL).
- LYMPHOMA ( Hodgkin’s Lymphoma & Non-Hodgkin’s Lymphoma)
Blood cancers are quite common and affect all ages and genders. ALL is more common in children. AML, CML, CLL, Lymphoma & Myeloma are more common in adults. According to the statistical data of United States, every three minutes, someone is diagnosed with blood cancer. In case of Nepal scenario too, the number of blood cancer cases are increasing in number.
SIGN & SYMPTOMS:
.Fever .Weakness .Fatigue .Petechiae & ecchymosis
.Gum bleeding .Epistaxis (nose bleeding) .Gum hypertrophy
.Bone pain .Lymphadenopathy .Hepato-spleenomegaly.
.Lymphadenopathy .Fever .weight loss .Night sweats
.Difficulty breathing/ chest pain .Itchy skin .Splenomegaly
.Bone pain .Weakness, malaise
.Renal failure .Infection .Confusion .Excessivethirst
TEST TO BE DONE FOR DIAGNOSIS:
.CBC .Peripheral Blood Smear .Bone marrow aspiration & biopsy
.Excisional lymphnode biopsy .IHC evaluation of the biopsy block
.CBC, RFT, Calcium, β2 microglobin
.Bone marrow aspiration & biopsy .24 hour Urine protein
.Serum Protein Electrophoresis/Serum immunofixation
.Urine Protein Electrophoresis/urine immunofixation
.Free light chain assay
. Idiopathic (cause unknown)
. Other risk factors:
. Environmental factors . Chemical exposure (e.g. benzene)
. Pesticides exposure . Radiation exposure
. Change in diet habits
. Certain Genetic disorders (e.g. Down’s syndrome)
. Secondary to certain chemotherapy or radiotherapy
Patients with blood cancer are generally treated with chemotherapy along with supportive management, in some cases radiotherapy is needed and in patients with high risk or relapsed cases bone marrow transplant is considered.
Blood Cancer Treatment in Nepal is still very challenging because of lack of awareness, human resources, technologies, few treating centers etc. But if we look at the past few years, we can see much more improvement in the treatment of Blood Cancer. Hematology service in Nepal is taking a milestone. With the introduction of qualified treating doctors & treatment Centers, People of Nepal with Blood Cancer are able to get better quality service within Nepal itself.