Infusion Nursing Notes by Nufactor provides education, resources and support to promote successful patient therapy within the infusion nursing community.

Hematologic Malignancies (Blood Cancers)


By Cindi Berry, RN, BSN

Hematologic malignancies are a type of cancer that affects blood, bone marrow and lymph nodes. Blood cancers affect the production and function of blood cells. Most of these cancers start in the bone marrow where blood is produced. Stem cells in the bone marrow mature and develop into three types of blood cells: red blood cells, white blood cells or platelets. In most blood cancers, the normal blood cell development process is interrupted by uncontrolled growth of an abnormal type of blood cell. These abnormal blood cells, or cancerous cells, prevent your blood from performing many of its functions, like fighting off infections or preventing serious bleeding.

The classification of hematologic malignancies includes leukemia (both chronic and acute), lymphomas (Hodgkin’s and non-Hodgkin’s), and multiple myeloma. Leukemia is a type of cancer found in the blood and bone marrow. This type of cancer interrupts the normal production of certain white blood cells and causes a rapid increase in the number of cells. Since white blood cells help the immune system fight infection, leukemia can put a patient at risk for an increase in infections. The increased number of abnormal white blood cells in the bone marrow can impair the production of other important cells such as red blood cells and platelets, which also are produced in the bone marrow. Leukemia is classified into two major groups: chronic and acute. Chronic leukemias are a group of diseases that cause an increase in abnormal white blood cells, but develop at a lower rate. Many people diagnosed with one of the chronic leukemias may not have any symptoms.

People diagnosed with a chronic leukemia can live many years without the need for treatment. Acute leukemia is characterized by a sudden onset of a significant increase of abnormal white blood cells. Patients with an acute leukemia usually have a sudden onset of symptoms such as a significant increase in bruises, bleeding gums or severe fatigue.

Lymphoma is a type of blood cancer that affects the lymphatic system. The lymphatic system helps to support the immune system by detecting agents such as bacteria and viruses. Many lymphomas originate from the lymphocyte cell line in the bone marrow or lymph nodes. These cells are a member of the white blood cells. Lymphocytes are characterized into two different types of cells: B cell and T cells.  The B cells are primarily responsible for fighting infections, while T cells are “helper cells” that aid in helping the body identify foreign matters. Lymphoma can interrupt the immune system by decreasing the ability to identify foreign matters if there are too many abnormal lymphocytes present.

Multiple myeloma is a type of blood cancer that specifically affects plasma cells. Plasma cells are derived from leukocytes, originating from the B cell line. Plasma cells play an important role in the immune system by helping the body fight infections. Plasma cells are responsible for creating antibodies. When a person is diagnosed with multiple myeloma, he or she may have a weakened immune system. Multiple myeloma can cause someone to be susceptible to infection due to the decrease in antibody production (ability to identify foreign objects).

Immune Globulin (IVIG) can be used as a therapy in blood cancers to help boost a patient’s immune system. Many of the blood cancers affect the B-cell blood line, which excretes immune globulin (IVIG).  Since patients may be deficient in IgG, we can help protect the patient’s immune system by administering replacement therapy in an effort to keep the immune system functioning well.

Source
1. American Society of Hematology. Blood Cancers. Accessed at www.hematology.org/Patients/Cancers.

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