Treatment Options for Blood Cancer: Understanding the Different Types

Getting a blood cancer diagnosis is an undoubtedly scary and overwhelming experience. Your mind is likely a sea of unknowns, flooded with questions: What will my life be like from now on? Can I enjoy the same things I used to? Can I be cured?

Even though a cancer diagnosis can fill you with feelings of uncertainty, asking the right questions about blood cancer treatment and learning everything you can about your options may help put you at ease—and give you the best treatment outcome.

“The advances in the treatment of blood cancer over the last 30 years have been quite impressive,” says Ruthee-lu Bayer, MD, director of stem cell transplantation at Northwell Health. “I am happy in this day and age to tell my patients that the odds are in their favor with the respect of long-term survival and cure.”

Blood Cancer Treatment Options

Blood diseases are very complex, so to get the best treatment possible, it’s important to be evaluated by hematologist-oncologist who specializes in treating your specific condition. “The treatment of the blood cancer depends on the type of blood cancer that the patient has and the goals of care for that specific patient,” says Dr. Bayer.

Watch and wait. With this method, doctors closely monitor the patient without giving treatment until their condition changes or new symptoms appear. “Immediate treatment may not be necessary, but the patient is monitored with scans and blood work. At the time where the patient is meeting certain criteria for treatment, that’s when the patient will be treated,” says Dr. Bayer. This approach is usually recommended for patients in early stages of indolent (slow-growing) or chronic forms of blood cancers.

Chemotherapy and other drug therapies. Chemotherapy is one of the mainstays of blood cancer treatment. Chemotherapy works by slowing down or stopping the rapid divide of cancer cells, but it can also affect healthy cells as well. “The white blood cell count can drop down, the red blood cells can drop down, and the platelets can drop down as well,” says Dr. Bayer. “[Patients undergoing chemotherapy] will often require transfusions of red blood cells and platelets.”

A blood transfusion uses blood cells donated by healthy volunteers to replace red cells, platelets and other blood components.

Radiation therapy can be used to treat leukemia, lymphoma, myeloma, and myelodysplastic syndromes. “The radiation therapy will damage the DNA in the cells and prevent them from growing,” says Dr. Bayer.

The radiation used for radiation therapy is the same kind that’s used for diagnostic X-rays, but at higher doses. “I often tell my patients to think of radiation as a special X-ray,” says Dr. Bayer.

Immunotherapy. “Immunotherapy is where we’re trying to harness the patient’s own immune system to help fight off the blood cancer,” says Dr. Bayer. Immunotherapies generally have fewer short-term side effects than chemotherapy. (Learn more about the difference between immunotherapy and chemotherapy here.)

Types of immunotherapy being used or studied to treat blood cancer include:

• Chimeric antigen receptor (CAR) T-cell therapy
• Donor lymphocyte infusion
• Monoclonal antibody therapy
• Radioimmunotherapy
• Reduced-intensity allogeneic stem cell transplantation
• Therapeutic cancer vaccines

“One of the main [immunotherapy] treatments for patients with high-risk blood cancer is stem cell transplantation,” says Dr. Bayer.

Stem cell transplantation can be autologous or allogeneic. Allogeneic means the doctors will use a donors stem cells to jumpstart a blood cancer patient’s immune system to fight the cancer.

With an autologous stem cell transplant, the goal is to give the patient a higher dose of chemotherapy. “We collect that patient’s stem cells, we freeze them, and we rescue that patient back with their own stem cells to repopulate their bone marrow [with healthy cells],” says Dr. Bayer.

Clinical trials. Clinical trials are carefully controlled research studies conducted by doctors to improve the care and treatment of people with certain conditions, including cancer. “Patients with a blood cancer who have failed first- and second-line treatments may consider treatment on a clinical trial,” says Dr. Bayer. 

“I try to remind patients that there are many newer treatments for these diseases, and I try to remind them that in this day and age, the odds are in their favor,” says Dr. Bayer.