New Treatment Options for Blood Cancer

Blood cancer. The words bring to mind scary thoughts about a terminal disease and cancer spreading throughout one’s body as the blood we need delivers both nourishment and potentially cancerous cells to other parts of our body.

Scientists and doctors once had few options but to fall in line with this perception, as they watched patients with leukemia, myeloma and lymphoma fight for their lives. But, now there are happier endings, thanks to a better understanding of how these types of cancers form in the first place and emerging treatments that target those processes.

“We’re witnessing a paradigm shift in the treatment of blood cancers,” said Peter Citron, M.D., a Baptist Health Medical Group hematologist/oncologist and a founding member of Miami Cancer Institute, a part of Baptist Health South Florida. “We now know that seeking out and destroying cancer cells is only part of the treatment equation. We’ve learned how to target the pathways that lead cells to become cancerous and stop them.”

Understanding Cancer

Dr. Citron points out that discoveries in the areas of genomics, or the study of genes and how they impact cells’ growth, and immunotherapy – how the body’s immune system can be used to attack cancer cells – have led to changes in the search-and-destroy approach to cancer treatment. The declining use of chemotherapy to treat certain blood cancers, he says, shows how research is moving toward more targeted therapies with improved rates of remission for patients. He notes that chemotherapy effectively destroys cancer cells, but it also can kill healthy cells, leading to significant side effects for patients.

Non-Chemotherapy Drugs Showing Promise

“The drugs we’re seeing great results with, especially in the treatment of chronic leukemia and lymphoma, work by blocking how cancer cells receive signals to start to grow,” Dr. Citron said. “For some chronic leukemia patients with certain cytogenetic profiles we can identify through genomics, we now have several new oral treatments that will put the patient into remission by preventing the further development of cancer cells.” Similar drugs target how lymphoma develops to stop the growth of those cancer cells in the body’s lymphatic system.

Treatment of Acute Leukemia

Dr. Citron says that chemotherapy is still the primary way to treat acute leukemia, which differs from the chronic type in the aggressive way its cancerous cells move from the bone marrow to the blood and on to other parts of the body.

Yet, like with the chronic version of leukemia, the patients’ cytogenetic and molecular data is increasingly crucial for diagnosis, prognosis and identification of treatment options. This information permits an understanding of which patients may need to undergo a bone marrow transplant from a relative or from a donor in a national registry. Some patients have also benefited from a transplantation of umbilical cord blood from a collection of blood taken immediately after a baby is born. In both of these therapies, stem cells from a donor are transplanted in the leukemia patient and help the body grow healthy cells to replace the cancerous ones.

Advances in Myeloma Treatment

For treating myeloma, or cancer of plasma cells, Dr. Citron says immunomodulatory drugs (IMiDs), and other new drugs that regulate the environment in which cells live and grow, have shown to improve patient survivability, too. In addition, he says that in the very near future, antibody therapy will be available for these patients. “While the standard of care for treating myeloma may still include high-dose chemotherapy, these newer drugs may ultimately remove the need for chemotherapy or sustain remissions for those who have had chemotherapy,” Dr. Citron explained.

“It’s an exciting time in the treatment of blood cancers,” Dr. Citron said. “Patients have so many more options than they did even 10 years ago, and we’re seeing survival rates improve as a result. While we used to have only chemotherapy and bone marrow transplants, we now have many more weapons at our disposal, and our understanding of these cancers helps us better choose the best weapon based on the patient.”