Anyone can develop blood cancers such as leukemia, lymphoma, or myeloma, says Raymond Hohl, MD, PhD, professor of internal medicine and pharmacology at Holden Comprehensive Cancer Center at The University of Iowa.

"They're spread through all ages. There's a tendency to have older individuals develop these cancers, with average age to be somewhere around 60. But certainly some of these disorders, especially the leukemias, can occur in children and are in fact one of the number one causes of cancer in children," Hohl says.  

"There also, for all of these disorders, tends to be a higher incidence in people in agricultural areas, presumably because of working with various chemicals or toxins that urban dwellers might not otherwise be exposed to."  

There also is a genetic link, though "not in what people would typically think," Hohl says. "There are rare disorders where people can be born with the genetic predisposition for these types of cancers or blood disorders. More commonly, we think that as people live and are exposed to various environmental potential toxins or just because of mere chance, individuals would develop genetic mutations in cells in their bone marrow. These cells are the origin for these types of cancers, and that can predispose people to develop cancer. In general, these cancers tend not to run in families."

According to Hohl, "The symptoms related to these cancers, or what would make somebody suspect that they might have this, would really be related to abnormalities in the normal blood count. For example, if an individual's red blood cells were low, they would be considered anemic, and they'd notice excessive fatigue. Someone might notice that they look very pale and that would be because their red blood cell count, or their hemoglobin levels, are low. If their white count or white blood cells are low, they might be predisposed to infections; and platelets-which are important for preventing bleeding-if they're low, people might notice very easy bruising."  

Once diagnosed with a blood cancer, people would probably see a hematologist or an oncologist, Hohl says. "A hematologist would deal probably more specifically with these types of blood cancers, although for some of them, such as myeloma, very commonly an oncologist (a practitioner dealing with a broader range of cancers) would be able to take care of them."

Unfortunately, with traditional chemotherapy agents, there are side effects to treating blood cancers, Hohl says. "However, in the big scheme of things, this is one area where we're very excited because we have many new therapies, so called "targeted therapies" that people have probably heard in the news, that are very, very selective for the cancerous or the leukemia or myeloma cell, for example, and doesn't tend to damage cells elsewhere in the body. And so the range of side effects can be very severe from traditional chemotherapy, quite honestly, to very minimal as related to some of these targeted areas. This is probably one of the greatest areas of advancement that we've had in the past five years or so."  

To learn about the latest research in treating blood cancers, "The simplest way would be to go to Web sites and look for cancer research. The National Cancer Institute (NCI) has a very nice Web site. Holden Comprehensive Cancer Center has a Web site with links to their site as well as others. The Leukemia and Lymphoma Society ... There are a host of different sites where people can get more information than they probably would ever want to know about these diseases," Hohl says.  

Hohl says there are many advantages to seeking out a NCI-designated center, such as Holden Comprehensive Cancer Center, for treatment. "Patients are assured that the people that are practicing are really at the cutting edge of what's available for treatment. Most importantly, individuals may have access to certain clinical trials that might not be so easily available in the community," he says. "Not to say these cancers can't be reasonably treated in the community, but there's a tendency to have more access to more, perhaps, innovative clinical trials through a comprehensive cancer center such as ours."

Holden Comprehensive Cancer Center is involved in quite a bit of research related to blood cancers. "In our laboratory, for example, we have studies that have combined traditional chemotherapy drugs with some of these targeted agents as a new treatment approach to certain types of an acute leukemia process, and we've made that available to patients here through clinical trials," Hohl says.

"There are other cancer center members at The University of Iowa that have ongoing trials for the treatment of lymphoma. And then the one approach that we have that's very different than might be available elsewhere is the availability of bone marrow transplant programs, which can really help people and really cure, we believe, a large percentage of these people."

The statistics for survival of leukemia, lymphoma and myeloma vary quite a bit, Hohl says. "For example, for leukemias in general, if you would say that maybe one out of 170 people might develop a leukemia during their lifetime, we think that overall we can cure about half of those people with one or more modalities.

"For multiple myeloma, it is probably somewhere between one in 80 to 100 or so people. We think that we can cure probably about 30 to 40 percent of this group with these treatments," Hohl says.  

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