Los cánceres de la sangre: Lo que debes saber

Existe un factor que a la larga nos pone a todos en riesgo en lo que se refiere a la mayoría de los cánceres de la sangre. El envejecimiento. Sin embargo, hasta que encontremos la elusiva Fuente de la Juventud, no podemos hacer nada para evitar envejecer. Tampoco existen pruebas de detección estandarizadas para detectar el cáncer de la sangre en sus primeras fases.

Sin embargo, las noticias sobre los cánceres de la sangre como la leucemia, el linfoma, el mieloma, el síndrome mielodisplásico y la neoplasia mieloproliferativa son bastante alentadoras, según los expertos de Baptist Health Miami Cancer Institute. El tratamiento ha evolucionado dramáticamente en la última década, lo que ha permitido la cura para algunos pacientes y una mayor supervivencia para otros.

“Afortunadamente, nos encontramos en una época en la que no existe un único tratamiento para el cáncer de la sangre”, afirma Guenther Koehne, M.D., Ph.D., subdirector y jefe de trasplante de sangre y médula ósea y oncología hematológica de Miami Cancer Institute. El Dr. Koehne, que es pionero en trasplantes de células madre e inmunoterapias, desarrolló una forma innovadora de manipular las células del donante para reducir el riesgo de la complicación potencialmente mortal conocida como enfermedad del injerto contra el huésped y proporcionar inmunoterapias novedosas dirigidas específicamente a las células cancerosas residuales.

Guenther Koehne, M.D., Ph.D., subdirector y jefe de trasplante de sangre y médula ósea y oncología hematológica de 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.