Blood Cancers: What You Need to Know

There’s one factor that puts us all at risk eventually when it comes to most blood cancers. Aging. Until we find the elusive Fountain of Youth, however, there’s nothing we can do about getting older. There are also no standardized screening tests to catch blood cancer in its early stages.

Yet the news about blood cancers such as leukemia, lymphoma, myeloma, myelodysplastic syndrome and myeloproliferative neoplasm is actually quite encouraging, according to experts at Baptist Health Miami Cancer Institute. Treatment has evolved dramatically in the last decade, leading to a cure for some and longer survival for others.

“Thankfully, we are now in an era where it is not one-treatment-fits-all for blood cancer,” says Guenther Koehne, M.D., Ph.D., deputy director of the Institute and chief of blood and marrow transplantation and hematologic oncology. A pioneer in stem cell transplantation and immunotherapies, Dr. Koehne developed an innovative way to manipulate donor cells to reduce the risk of the life-threatening complication known as graft-versus-host disease and to provide novel immunotherapies specifically targeting residual cancer cells.

Guenther Koehne, M.D., Ph.D., deputy director and chief of blood and marrow transplantation and hematologic oncology at Baptist Health Miami Cancer Institute

“Today we have targeted therapies and immunotherapies, and we are beginning to see patients living much longer with these blood cancers. It’s almost as if they have a chronic disease like diabetes,” he says. “It’s about managing the disease and having a good quality of life.”

The basics on blood cancer

September is Blood Cancer Awareness Month. While someone in the U.S. dies about every nine minutes from blood cancer, another 1.6 million are living with, or are in remission from, the disease, says the Leukemia and Lymphoma Society.

Blood cells originate in the bone marrow found inside most bones. If the cells develop abnormally, they begin to crowd out the healthy cells and prevent normal functioning, which includes carrying oxygen and nutrients throughout the body and fighting infection.

Although the risks are largely unknown (aging being the exception), there is an increased chance of developing blood cancer with radiation exposure and certain types of chemical exposure. Occasionally there is a genetic component.

Some patients have no symptoms or vague signs of illness that they attribute to the flu or their hectic lifestyle. For others, blood cancer is suspected after routine blood work comes back abnormal. Symptoms can include fevers, unexplained weight loss, night sweats, frequent infections, nose bleeds or easy bruising, or enlarged lymph nodes. It’s important, Dr. Koehne says, to head to your primary care physician if something seems off.  

Sophisticated treatments

If the diagnosis is blood cancer, going to a high-volume, experienced center is key. Treatments include chemotherapy, targeted therapy, immunotherapy, radiotherapy and stem cell transplants — or a combination. At Miami Cancer Institute, patients work with a team of specialized physicians to develop a treatment plan depending on the type and severity of illness.

With Dr. Koehne at the helm, the Institute launched its blood and marrow transplantation program in 2018 when it began offering autologous stem cell transplants (cells from the patient’s own body). In 2019, the allogeneic (donor cells) transplant program began.

Since its start, the Institute has performed more than 300 transplants. The number of consultations has more than quadrupled, as has the number of physicians on the team. It is the number-one-ranked hospital for leukemia, lymphoma and myeloma in South Florida by U.S. News & World Report.

Research leads to breakthroughs

While it may seem that cancer breakthroughs happen overnight, it is more typical that transformative changes in care come from years of research. “Thanks to clinical trials, more treatment options are available, and patients are living longer,” Dr. Koehne says. “Many patients are now able to avoid the most toxic chemotherapies that can have serious side effects, and we are able to provide options for much older individuals, who even two years ago would have been considered too risky to treat.”

A few of the current blood cancer clinical trials at the Institute are:

·      A trial led by Yuliya Linhares, M.D., chief of Lymphoma Services, for patients with relapsed/refractory B-cell lymphoma. The study is investigating bispecific anti-CD19/CD20 chimeric antigen receptor (CAR) T-cell therapy that targets two tumor antigens at once.

·      A trial led by Dr. Koehne for patients with CD33+ acute myeloid leukemia. The study uses CRISPR technology to remove the protein CD33 from the surface of healthy cells, allowing drugs to better target and kill the leukemia cells that are still expressing CD33.

·      A novel approach using a monoclonal antibody that targets galectin-9, a protein that is overproduced in leukemia cells. By reducing the expression of galectin-9, the hope is that the immune system is reactivated so that it can better kill the cancer cells. Led by Dr. Koehne.

Dr. Koehne and his colleagues will be presenting their leading-edge research at the American Society of Hematology (ASH) annual meeting in December in San Diego. ASH represents the premier worldwide network of clinicians and scientists committed to overcoming blood disorders.

“We still have work to do to prevent relapse, which is common for about half of all patients with blood cancers,” Dr. Koehne says. “But we are confident that our research will continue to lead to major improvements for our patients, and eventually cures.”

For more information on the Institute’s blood cancer and blood and marrow transplantation program, click here.