Other Blood Cancers and Conditions
At the OHSU Knight Cancer Institute, we have a team of doctors exclusively dedicated to diagnosing and treating less common hematologic diseases. These diseases include:
In aplastic anemia, your bone marrow stops producing new blood cells. This means you do not have enough red blood cells, white blood cells or platelets. White blood cells fight germs, and platelets help blood clot. Without these, you are at risk for infection and uncontrolled bleeding.
Aplastic anemia can be mild, moderate or severe. Mild or moderate aplastic anemia is serious but usually does not require a stay in the hospital. If you have mild or moderate aplastic anemia, your treatment might include:
- Blood transfusion, medications or both
- Immunosuppressive drugs
- Growth factors
Severe aplastic anemia, in which blood cell counts are extremely low, is life-threatening. If you have severe aplastic anemia, you need treatment in the hospital immediately. Treatment is usually a stem cell transplant. Replacing diseased bone marrow with healthy bone marrow from a donor can often cures aplastic anemia.
Myelodysplastic syndrome (MDS) is a condition in which abnormal stem cells in the bone marrow interfere with the production of healthy red blood cells, white blood cells and platelets. They also create defective bone marrow cells, which then make abnormal red blood cells, white blood cells and platelets. If you have MDS, you probably have plenty of cells in your bone marrow but not in your blood.
If you have mild MDS that affects your normal activities just a little or not at all, your doctor may recommend “watchful waiting.” This means your doctor will see you regularly, do tests and watch to see if your condition gets better or worse. You might go for several years with no major health changes.
Another approach to MDS treatment is supportive care to help reduce symptoms. This may include:
- Growth factors to increase your red blood cell, white blood cell or platelet counts and medicines to adjust your immune system
- Blood transfusions to add red blood cells or platelets to your bloodstream if medicines do not increase your levels enough
- Antibiotics to fight bacterial or fungal infections that your white blood cells cannot fight on their own
- Antiviral drugs to fight certain viral infections that respond to these medicines
If you have more severe symptoms, your doctor will probably recommend more treatment. This may include chemotherapy, which can lower your blood cell counts at first but can lead to remission (a period when MDS activity cannot be detected), stem cell transplantation or other newer treatments.
Myelofibrosis is a serious bone marrow disorder that disrupts the way your body normally producesblood cells. It leaves scars in your bone marrow, leading to severe anemia, weakness, fatigue and often an enlarged spleen and scar tissue on the liver. If you have serious symptoms or complications, treatment options include:
- Blood transfusions
- Androgen therapy
- Chemotherapy- Hydroxyurea (Hydrea) is the most commonly used chemotherapy drug in treating myelofibrosis.
- Radiation therapy- radiation may help a small number of people who have bone pain. It can also help reduce the size of the spleen, when surgical removal isn't an option.
- Thalidomide with steroids
Myeloproliferative disorders (MPDs) diseases in which the bone marrow makes too many cells. They are related to myelodysplastic syndrome (MDS), and acute myeloid leukemia, but most people with MPDs do better than people with those conditions.
Waldenstrom's macroglobulinemia is a rare chronic form of lymphoma that affects blood plasma cells. It mainly affects people 65 and older, and is most common in white men. Waldenstrom's is a slow-growing disease that spreads slowly and is easily controlled with treatment when diagnosed early.
As with other types of non-Hodgkin's lymphomas, the most effective treatment is chemotherapy, usually a combination of two or more drugs. In some cases, your plasma is removed and replaced in a procedure calledplasmapheresis. Younger patients may need a bone marrow transplant.
Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in a hematopoietic stem cell. The mutated cell expands in the bone marrow. If you have this mutation, it usually appears in adulthood. The disorder is not inherited or passed down to children.
If you have PNH, you can also develop aplastic anemia, which is anemia with a lower platelet and white blood count. Some patients who have aplastic anemia develop PNH. If you have PNH, you have a higher risk of developing blood. which can cause symptoms such as severe leg, abdominal or chest pain, shortness of breath, jaundice or headache.
If you have PNH with hemolytic anemia, your treatment might include blood transfusion, folic acid and iron supplements. Low red blood cell, platelet and white cell counts can be treated with steroids or the same immunosuppressive drugs used to treat aplastic anemia. Blood clots are usually treated with anticoagulants, and sometimes, if severe, with tissue plasminogen activator (TPA). PNH can be cured by bone marrow transplantation. Your doctor can tell you if this procedure is right for you based on the your age and symptoms.
In histiocytosis, also called Langerhans' cell histiocytosis or eosinophilic granuloma, there are too many of a type of cell called histiocytes or macrophages in the tissues. This disease affects the soft tissues and the bones and can also affect the endocrine system.
This rare disease can be difficult to diagnose. It has different forms, and can be different in children and adults. If you have histiocytosis, you may have damaged areas called lesions in your bones, mouth and gums or skin. Doctors might use chemotherapy or low doses of radiation therapy to treat skin or bone lesions. You might also have surgery to treat or prevent complications from this disease.
If you have systemic mastocytosis, you have too many of the cells involved in allergic reactions, called mast cells. Mastocytosis can be present only in the skin, or you can have numbers of mast cells throughout the body, including the digestive tract and bone marrow. Symptoms of systemic mastocytosis include allergic skin reactions, difficulty concentrating and diarrhea.
Doctors diagnose systemic mastocytosis by taking a small tissue sample called a biopsy. If they find mast cells in parts of the body other than the skin, you have systemic mastocytosis. This disease is usually treated with antihistamines, but systemic mastocytosis can also be treated with chemotherapy.