Health Facts

Hematologic Cancer

Most hematologic cancers, also known as blood cancer, start in the bone marrow, where the blood cells are produced and matured. Stem cells in your bone marrow grow and divide into three types of blood cells: red blood cells, white blood cells and platelets. When the normal blood cell development process is interrupted, it results in either drastically increased or decreased levels of immature blood cells, resulting in cancer.

Broadly there are three types of blood cancers:

  • Leukemia (of blood and bone marrow in general)
  • Lymphoma (of lymphocytes, a kind of white blood cells)
  • Myeloma (of plasma cells, a kind of white blood cells)
Recent genome advancements have made it possible for prediction of blood cancers and understanding the risk percentage of blood cancer by analysing individual’s gene make up and family history.

Risk Factors of Haematological Cancers

Some people are at more risk of developing haematological cancers than others, these include the ones with:

  1. A family history of haematological cancers
  2. A personal and family history of longstanding blood count abnormalities of unknown cause
  3. A family history of know inheritable forms of blood cancers such as:
    • Familial platelet disorder with propensity for myeloid malignancies (RUNX1 mutation)
    • Familial MDS/AML due to GATA2 mutation
    • Familial AML due to CEBPA mutation
    • Telomere syndromes or other inherited bone marrow failure conditions
  4. A personal or family history of following blood abnormalities:
    • Fanconi anaemia
    • Diamond-Blackfan anaemia
    • Shwachman-Diamond syndrome
    • Dyskeratosis congenita/telomere biology disorders

Common genes responsible for haematological cancers

Although there are many genes that may be responsible for development of haematological cancer, aberrations in the following genes are the most common:

  • RUNX1 gene
  • CEBPA gene
  • GATA2 gene

Assessment of Haematological Cancer Risk

Assessment of cancer risk is recommended who is at high risk based on the factors mentioned above. The following tests and assessment can be performed to assess the cancer risk in a vulnerable person.

Detailed family history including analysis of at least 3 generations

Personal history

Bone marrow assessment through biopsy and aspiration

Relevant genetic tests for chromosomal abnormalities

Anybody undergoing cancer risk assessment process should be thoroughly counselled by experts and further recommendation should be provided for clinical follow-up and screening.

FAQ's :

Yes, some types of blood cancer are hereditary. A family history of blood cancer can increase an individual’s risk of developing blood cancer. E.g. – Leukemia myelodysplastic syndrome (MDS), lymphoma and multiple myeloma.

Yes, genetic testing is available for blood cancer risk predication by evaluating gene make up and family history.

Biomarker testing for cancer treatment is one of the genetic advances available.

Although, the hereditary nature of a blood cancer can be only confirmed through genetic testing, some features may indicative a likelihood of the cancer being hereditary. These include presence of multiple malignancies, family history of hematological neoplasms, long-lasting thrombocytopenia, not explained by other reasons, congenital abnormalities, excessive treatment toxicities, delay count recovery after chemotherapy or poor stem cell mobilization.

References:

  1. Blood cancers. American Society of hematology. https://www.hematology.org/education/patients/blood-cancers Accessed on 01-06-2022
  2. Hematologic cancer. National cancer institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hematologic-cancer Accessed on 01-06-2022
  3. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373 Accessed on 01-06-2022
  4. Risk Factors for Acute Myeloid Leukemia (AML). American Cancer Society. https://www.cancer.org/cancer/acute-myeloid-leukemia/causes-risks-prevention/risk-factors.html Accessed on 01-06-2022
  5. Blood cancer. Cancer treatment centers of America. https://www.cancercenter.com/blood-cancers Accessed on 01-06-2022

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