Blood cancers remain a challenging group of diseases, with many types and subtypes. But we’ve made great strides in diagnosis and treatment, with additional, promising therapies on the way.
Our treatments are research-backed and individualized, with the latest approaches for chemotherapy and radiation and a full range of newer targeted therapies. We also take part in some of the most promising research and clinical trials in the nation and offer the region’s largest stem cell transplant program.
Chemotherapy is one of the main treatments for blood cancers, and is usually swallowed or injected into a vein. The drug(s) travel throughout the bloodstream to destroy cancerous cells, and are often used in combination with other therapies — sometimes preceding stem cell transplants to restore healthy blood cells.
We offer the latest, most effective chemotherapy drugs, with our researchers and others studying and developing ways to improve therapy while limiting side effects:
- New drugs, new combinations and new sequences
- Ways to counter cell resistance to chemotherapy
- Less intense doses and shorter regimens that still kill cancerous cells
- Identifying which patients need more intensive treatment and which can do with less
Chemotherapy Precautions for Blood Cancer Patients
While we always work to minimize chemotherapy side effects, we take additional precautions for those at higher risk:
- Older patients, who often have a harder time tolerating treatments
- Pregnant women, who should either deliver before treatment (ideally) or only receive certain drugs in certain trimesters
- Younger patients, who often respond to and tolerate chemotherapy better than adults but who are still growing
We also use drugs to speed the recovery of white blood cells after chemotherapy, to reduce your risk of infection.
Intrathecal Chemotherapy and Blood Cancer
Regular chemotherapy usually doesn’t reach the brain and spinal cord (the central nervous system, or CNS), which can provide a hiding place for cancerous cells. If needed, we can avoid that by injecting drugs into the cerebrospinal fluid, a procedure called intrathecal chemotherapy.
Blood Cancer and Stem Cell Transplants
Sometimes higher doses of chemotherapy drugs are required to treat blood cancers, doses that damage the bone marrow where blood cells are produced. If that’s the case, we provide a restorative transplant of blood-forming stem cells, taken either from the blood (more common) or the bone marrow (less frequent now). There are two possible sources:
- Allogenic: the stem cells come from a donor (most likely a close relative because of the need to match immune system characteristics)
- Autologous: the stem cells are taken from your body before the chemotherapy and stored
Stem cell transplants are a normal part of multiple myeloma treatment. But we usually don’t turn to high-dose chemotherapy and a stem cell transplant for leukemia or lymphoma unless other treatments have not worked or the disease has returned (recurred). In the case of chronic myeloid leukemia (CML), we now try a targeted therapy (like Gleevac) first. Learn more about our blood targeted therapy.
Blood Targeted Therapy
Targeted therapy represents a new front in attacking cancer — drugs and other substances aimed at specific molecules that help a disease grow, progress and spread. The idea is to target a cancer’s unique characteristics, including genes, proteins, supporting blood vessels or host tissue, while limiting damage to healthy cells.
Several targeted therapies are already approved for treating blood cancers, with additional prospects in clinical trials. Targeted therapies are typically used by themselves or in combination with chemotherapy. They are given as an initial treatment or in more challenging scenarios, such as when there’s no response to other therapies or the cancer has returned (recurred).
Types of Blood Cancer Targeted Therapy
We offer a number of targeted therapies, aimed at various blood cancers and the specific characteristics of the cells they create:
- Tyrosine Kinase Inhibitors (TKIs): TKIs target the gene BCR-ABL, which is formed by an abnormal chromosome (the Philadelphia mutation) and makes a protein that helps cancer grow. TKIs are the main treatment for chronic myeloid leukemia (CML) and are also used for some acute lymphoblastic leukemia (ALL) patients who have the mutation.
- Monoclonal Antibody: These drugs replicate a natural antibody and target certain substances on cancer cells — either alone or with a drug, toxin or radioactive material to kill the cells, block their growth or keep them from spreading.
- Proteosome Inhibitors: These inhibitors stop cell enzymes from breaking down proteins that keep cell division under control. They are often used to treat multiple myeloma but are also helpful for some types of non-Hodgkin lymphoma.
- Histone Deacetylase (HDAC) Inhibitors: These drugs change which genes are active by working with a chromosome protein called histone.
- FLT3 Inhibitors: These drugs target mutations in the FLT3 gene in patients with acute myeloid leukemia (AML).
- Cancer Vaccines: They are designed to treat, not prevent, blood cancer by boosting the immune system’s response.
- Interferon: This manmade version of a white blood cell protein can interfere with cancer cell division and slow tumor growth. It is used to treat multiple myeloma or lymphoma in some patients.
Radiation therapy for blood cancers uses high energy X-rays or other particles from an external machine to kill cancerous cells and shrink tumors. While radiation is not used as frequently as other treatments like chemotherapy and targeted therapy, there are useful applications:
- Hodgkin Lymphoma: While radiation is usually very effective for killing diseased cells in Hodgkin lymphoma, we try to limit its use because of side effects. Thanks to advanced imaging, we can target the disease more precisely and further avoid damage to healthy tissues.
- Non-Hodgkin Lymphoma: We might recommend radiation alone for early-stage tumors, or with chemotherapy for more aggressive disease. We might also pair it with high-dose chemotherapy before a stem cell transplant.
- Multiple Myeloma: Radiation is a possible treatment for painful bone damage when chemotherapy doesn’t help.
Whatever the application, we are careful to minimize radiation side effects, particularly for patients who are younger, pregnant or older.