What Is Bone Marrow Cancer?
Bone marrow cancer is a form of cancer that starts in the spongy tissue -- the marrow -- inside your bones. Marrow’s main job is to make blood cells.
There are many different types of blood and bone marrow cancer. Here are a few:
- Multiple Myeloma. This is the most common. It affects plasma cells. These are white blood cells that help fight infection and disease. In multiple myeloma, cancerous plasma cells push out normal, healthy ones and destroy or weaken your bones.
- Lymphomas. These usually begin in lymph nodes, but they can also affect the bone marrow. Non-Hodgkin’s lymphoma starts in the lymphocytes, a type of white blood cell. White blood cells are part of the body's immune system.
- Leukemia. If you have this type of blood cancer, your body makes abnormal blood cells. These abnormal cells crowd the bone marrow so there is less room for healthy blood cells. Usually it forms in the white blood cells, but it can happen in other types of cells, too. It can be either fast-growing (acute) or slow-growing (chronic). There are many types of leukemia. All of them have different treatments.
- Childhood Leukemia. This is the most common form of cancer in children and teens. About 3 out of every 4 childhood leukemias are acute lymphocytic leukemia. This starts in the bone marrow from early forms of white blood cells and progresses quickly. The rest are usually acute myeloid leukemia. This type of cancer starts in another early form of blood cell and can move quickly into the blood and spread to other parts of the body.
Who’s At Risk?
A risk factor is something that affects your chance of getting a disease. Different cancers have different risk factors. But just because you’re at risk doesn’t mean you’ll actually get sick. And, most people who do get bone marrow cancer have no known risks. Talk to your doctor about your concerns.
Here’s a list of some known risk factors for some more common blood and bone marrow cancers.
Multiple myeloma. Your chances of getting this type of bone marrow cancer goes up as you age. It’s highest if you’re over age 65. Men get it more than women. And, it’s more common among African-Americans than whites. Other risk factors include:
- A family history of myeloma
- Working in the oil industry
- Obesity or being overweight
- A history of other plasma cell diseases
Lymphoma. This is more common among people over age 60. White people in the U.S. are more likely to develop it compared to African-Americans or Asian-Americans.
Additional risk factors for lymphoma are:
- Exposure to chemicals such as benzene, chemotherapy, and radiation therapy for other cancers
- Autoimmune conditions like rheumatoid arthritis, lupus, and Sjogren’s Syndrome
- Certain infections, like HIV or hepatitis C
- Being overweight or obese
- In rare cases, having breast implants
Acute Myeloid Leukemia. This is more common among men. Risk factors include:
- Long-term exposure to certain chemicals such as benzene
- Chemotherapy drug treatment for other cancers
- Radiation exposure, even to low doses such as X-rays or CT scans
- Certain blood problems
- Congenital diseases including Down syndrome
- Family history of the illness
Chronic Myeloid Leukemia. You may be at risk due to:
- High-dose radiation exposure (such as from a nuclear reactor accident).
- Age. Your risk goes up as you get older.
- Gender. It’s slightly more common in men than in women.
Childhood Leukemia. Most kids with this disease don’t have any risk factors. And doctors don’t know exactly what causes it. Some things that may increase a child’s or teen’s chances of getting it include:
- Syndromes including Down Syndrome, Fanconi anemia, or other genetic syndromes
- Having another form of bone marrow disease
- Having a sibling with leukemia, especially an identical twin
- High-level radiation exposure (which can occur from treatment of a previous cancer)
- Chemotherapy drugs and other chemicals, like benzene
- Immune suppression therapy (such as for organ transplant recipients)
Doctors will check your bone marrow to see if it’s making normal amounts of blood cells. This is called a bone marrow test. There are two types -- aspiration and biopsy.
In the first type, your doctor takes a small amount of your bone marrow fluid with a needle. That will give them some idea what the problem is. It’ll also let them know if you have a fever or infection.
If your doctor needs more information, he’ll do a bone marrow biopsy. He’ll remove a small piece of marrow through a bigger needle.
Both tests are simple and safe for most people.
Treatment depends on the type of cancer you have, how far it has spread, and other factors.
The main treatments are:
- Chemotherapy (Chemo). Doctors inject cancer-fighting drugs into your body, or you take them by mouth. They may be used with radiation or other drugs.
- Immunotherapy. This treatment boosts your immune system. It may also use man-made versions of your immune system to kill cancer cells or slow their growth.
- Targeted therapy drugs. These drugs pinpoint the changes that happen in your body’s cells to cause cancer. They often have less severe side effects than chemo.
- Radiation. Special x-rays and gamma rays are used to attack and shrink tumors. Radiation kills cancer cells by destroying their DNA.
- Stem cell transplant. During chemo, cancerous bone marrow cells are killed off. In high-dose chemo, the stem cells that form blood in your bone marrow are also destroyed. A stem cell transplant -- also called a bone marrow transplant -- creates more of the cells that grow in your marrow. After chemo or radiation, you’ll get them through an IV, an injection into your veins.