Cancer that affects the bone marrow causes different symptoms depending on the cancer type. Your oncologist can tell you what cancer you have, as well as what symptoms and treatment you can expect.
Marrow is the sponge-like material inside your bones. Located deep within the marrow are stem cells, which can develop into red blood cells (RBCs), white blood cells (WBCs), or platelets.
Bone marrow cancer happens when cells in the marrow begin to grow abnormally or at an accelerated rate. Cancer that starts in the bone marrow is called bone marrow cancer or blood cancer. Bone marrow cancer is distinct from bone cancer.
Other types of cancer can spread to your bones and bone marrow, but they’re not classified as bone marrow cancer.
Continue reading to learn about the different types of bone marrow cancer, how they’re diagnosed, and what you can expect.
Symptoms will depend on the type of cancer you have.
Multiple myeloma
The most common type of bone marrow cancer is multiple myeloma. The signs and symptoms may include:
- anemia, or weakness and fatigue due to the shortage of RBCs
- leukopenia, or infections due to the shortage of normal WBCs
- thrombocytopenia, or bleeding and bruising due to low blood platelets
- frequent urination
- extreme thirst
- dehydration
- abdominal pain
- loss of appetite
- drowsiness
- confusion due to hypercalcemia, which is high levels of calcium in the blood
- bone pain or weakened bones
- kidney damage or kidney failure
- peripheral neuropathy, or tingling due to nerve damage
Leukemia
Leukemia usually involves WBCs. Some signs and symptoms of leukemia are:
- fever and chills
- weakness and fatigue
- frequent or severe infections
- unexplained weight loss
- swollen lymph nodes
- enlarged liver or spleen
- bruising or bleeding easily, which includes frequent nosebleeds
- petechiae, or tiny red dots on the skin
- excessive sweating
- night sweats
- bone pain
Lymphoma
Lymphoma can start in the lymph nodes or the bone marrow. Some signs and symptoms of lymphoma are:
- fever and chills
- low energy
- unexplained weight loss
- swollen lymph nodes
- swelling in the neck, underarm, arm, leg, or groin
- night sweats
- nerve pain, numbness, and tingling
- feeling of fullness in the stomach
- chest or lower back pain
- rash or itching
There are three major types of bone marrow cancer.
Multiple myeloma
Multiple myeloma starts in the plasma cells. These are WBCs that make antibodies to protect your body from foreign invaders.
Tumors form when your body starts to produce too many plasma cells. This can lead to bone loss and a decreased ability to fight infections.
Leukemia
In leukemia, the body produces abnormal blood cells that do not die off as they should. As their numbers grow, they swarm WBCs, RBCs, and platelets, interfering with those cells’ and platelets’ ability to function.
Acute leukemia involves immature blood cells, called blasts, and symptoms can progress quickly. Chronic leukemia involves more mature blood cells. Symptoms of chronic leukemia can be mild at first, so you might not know you have it for years.
There are many types of leukemia, including:
- acute myeloid leukemia, which affects children and adults
- acute lymphocytic leukemia, which affects children and adults
- chronic myeloid leukemia, which mainly affects adults
- chronic lymphocytic leukemia, which affects adults
Learn more about the differences between acute and chronic leukemia.
Lymphoma
In lymphoma, lymphocytes, or cells, grow out of control, forming tumors and making it difficult for your immune system to do its job.
There are two main types of lymphoma.
Hodgkin’s lymphoma, also known as Hodgkin’s disease, starts in specific B lymphocytes. The other type, non-Hodgkin’s lymphoma, starts in B or T lymphocytes. There are also many subtypes.
It’s not clear what causes bone marrow cancer. Contributing factors may include:
- exposure to toxic chemicals in solvents, fuels, engine exhaust, certain cleaning products, or agricultural products
- exposure to atomic radiation
- certain viruses, including HIV, hepatitis, some retroviruses, and some herpes viruses
- a suppressed immune system or plasma disorder
- genetic conditions or a family history of bone marrow cancer
- previous chemotherapy or radiation therapy
- smoking
- obesity
If you have signs or symptoms of bone marrow cancer, a doctor will review your medical history and do a complete physical examination.
Depending on those findings and your symptoms, diagnostic testing may involve:
- blood tests, such as a complete blood count, complete metabolic profile, and tumor markers
- urine tests to check protein levels and assess kidney function
- biopsy of the bone marrow or an enlarged lymph node to check for the presence of cancerous cells
- imaging tests such as CT scans, MRIs, PET scans, and X-rays to look for evidence of tumors
The results of the biopsy can confirm a bone marrow cancer diagnosis and provide information about the specific type of cancer. Imaging tests can help determine how far the cancer has spread and which organs are affected.
Treatment for bone marrow cancer will vary by individual. It’s based on the specific type and stage of cancer at diagnosis, as well as any other health considerations.
The following treatments are used for bone marrow cancer:
- Chemotherapy. Chemotherapy is a systemic treatment designed to find and destroy cancer cells in the body. Your doctor will prescribe a drug or combination of drugs based on your specific type of cancer.
- Radiation therapy. Radiation therapy delivers high-energy beams to a targeted area in order to kill cancer cells, reduce tumor size, and ease pain. Discover how radiation therapy compares to chemotherapy.
- Biological therapy. This therapy uses your own immune system to kill cancer cells.
- Targeted therapy drugs. Targeted therapy drugs attack specific types of cancer cells in a precise manner. Unlike chemotherapy, they prevent damage to healthy cells.
- Transplant. During a bone marrow transplant, damaged bone marrow is replaced with healthy marrow from a donor. This treatment may involve high-dose chemotherapy and radiation therapy. It’s also known as a stem cell transplant.
Participating in a clinical trial is another treatment option. Clinical trials are research programs that test new treatments that have not yet been approved for general use. They generally have strict eligibility guidelines. Your doctor can help you find information on trials that might be a good fit.
Relative survival statistics show which percentage of people with a cancer diagnosis survived in comparison to people who did not have that cancer. When looking at survival rates, it’s important to remember that they vary from person to person.
These rates reflect the survival of people who were diagnosed years ago. Since treatment is rapidly improving, it’s possible that survival rates are better than these figures indicate.
Some types of bone marrow cancer are much more aggressive than others. Generally speaking, the earlier a doctor diagnoses cancer, the better your chances for survival. Outlook depends on factors unique to you, such as your overall health, your age, and how well you respond to treatment.
Your doctor will be able to provide more information on what you can expect.
General outlook for multiple myeloma
Multiple myeloma is not usually curable, but it can be managed. Treatment can improve overall quality of life.
According to the National Cancer Institute’s
| Stage of multiple myeloma | 5-year relative survival rate (from 2011 to 2017) |
|---|---|
| Local stage | 77.5% |
| Distant stage (cancer has metastasized) | 54.5% |
General outlook for leukemia
Some types of leukemia can be cured. For example, the five-year survival rate for children with acute lymphocytic leukemia is
According to
General outlook for lymphoma
Hodgkin’s lymphoma is very treatable. When found early, both adult and childhood Hodgkin’s lymphoma can usually be cured.
According to
| Stage of Hodgkin’s lymphoma | 5-year relative survival rate (from 2011 to 2017) |
|---|---|
| Stage 1 | 92.2% |
| Stage 2 | 94.3% |
| Stage 3 | 85.5% |
| Stage 4 | 78.5% |
| Unknown stage | 83.5% |
According to
| Stage of non-Hodgkin’s lymphoma | 5-year relative survival rate (from 2011 to 2017) |
|---|---|
| Stage 1 | 84.3% |
| Stage 2 | 77.1% |
| Stage 3 | 71.1% |
| Stage 4 | 63.7% |
| Unknown stage | 75.1% |
If you’ve received a bone marrow cancer diagnosis, you probably have a lot of questions about what to do next.
Here are a few things to discuss with your oncologist:
- the specific type and stage of cancer
- your treatment goals
- what tests will be conducted to check on your progress
- what you can do to manage symptoms and get the support you need
- whether a clinical trial is right for you
- your outlook based on your diagnosis and overall health
Ask for clarification if you need it. Your oncologist is there to help you understand your diagnosis and treatment options. Communicating openly with them will allow you to make the best decision for your treatment.