Marrow is the sponge-like material inside your bones. Located deep within the marrow are stem cells, which can develop into red blood cells, white blood cells, and 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, not bone cancer.
Other types of cancer can spread to your bones and bone marrow, but they’re not bone marrow cancer.
Continue reading to learn about the different types of bone marrow cancer, how it’s diagnosed, and what you can expect.
The most common type of bone marrow cancer is multiple myeloma. It starts in the plasma cells. These are white blood cells 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 usually involves white blood cells.
The body produces abnormal blood cells that don’t die off as they should. As their numbers grow, they swarm normal white blood cells, red blood cells, and platelets, interfering with their ability to function.
Acute leukemia involves immature blood cells, called blasts, and symptoms can progress quickly. Chronic leukemia involves more mature blood cells. Symptoms can be mild at first, so you might not know you have it for years.
There are many types of leukemia, including:
- chronic lymphocytic leukemia, which affects adults
- acute lymphocytic leukemia, affects children and adults
- chronic myelogenous leukemia, which mainly affects adults
- acute myelogenous leukemia, which affects children and adults
Lymphoma can start in the lymph nodes or the bone marrow.
There are two main types of lymphoma. One is Hodgkin’s lymphoma, also known as Hodgkin’s disease, which starts in specific B lymphocytes. The other type is non-Hodgkin’s lymphoma, which starts in B or T cells. There are also many subtypes.
With lymphoma, the lymphocytes grow out of control, forming tumors and making it difficult for your immune system to do its job.
Signs and symptoms of multiple myeloma may include:
- weakness and fatigue due to shortage of red blood cells (anemia)
- bleeding and bruising due to low blood platelets (thrombocytopenia)
- infections due to shortage of normal white blood cells (leukopenia)
- extreme thirst
- frequent urination
- abdominal pain
- loss of appetite
- confusion due to high levels of calcium in the blood (hypercalcemia)
- bone pain or weakened bones
- kidney damage or kidney failure
- peripheral neuropathy, or tingling, due to nerve damage
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, including frequent nosebleeds
- tiny red dots on the skin (petechiae)
- excessive sweating
- night sweats
- bone pain
Some signs and symptoms of lymphoma are:
- swelling in the neck, underarm, arm, leg, or groin
- enlarged lymph nodes
- nerve pain, numbness, tingling
- feeling of fullness in the stomach
- unexplained weight loss
- night sweats
- fever and chills
- low energy
- chest or lower back pain
- rash or itching
It isn’t 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
- suppressed immune system or plasma disorder
- genetic disorders or family history of bone marrow cancer
- previous chemotherapy or radiation therapy
If you have signs of bone marrow cancer, your 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 complete blood count, chemistry profile, and tumor markers
- urine tests to check protein levels and assess kidney function
- imaging studies such MRI, CT, PET, and X-ray to look for evidence of tumors
- biopsy of the bone marrow or enlarged lymph node to check for the presence of cancerous cells
The results of the biopsy can confirm a bone marrow diagnosis and provide information about the specific type of cancer. Imaging tests can help determine how far the cancer has spread and what organs are affected.
Treatment for bone marrow cancer will be individualized and 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 you a drug or combination of drugs based on your specific type of cancer.
- Biological therapy. This therapy uses your own immune system to kill cancer cells.
- Targeted therapy drugs. These drugs attack specific types of cancer cells in a precise manner. Unlike chemotherapy, they prevent damage to healthy cells.
- Radiation therapy. Radiation therapy delivers high-energy beams to a targeted area to kill cancer cells, reduce tumor size, and ease pain.
- Transplant. With a stem cell or bone marrow transplant, damaged bone marrow is replaced with healthy marrow from a donor. This treatment may involve high-dose chemotherapy and radiation therapy.
Participating in a clinical trial may be another option. Clinical trials are research programs that test new treatments that haven’t 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 compare the survival of people with a cancer diagnosis to people who don’t have cancer. When looking at survival rates, it’s important to remember that they vary from person to person.
These rates reflect 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 you catch cancer, the better your chances for survival. Outlook depends on factors unique to you, such as your overall health, 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.
According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program data from 2008 to 2014, the five-year relative survival rates for multiple myeloma are:
|Distant stage (cancer has metastasized)||49.6%|
General outlook for leukemia
Some types of leukemia can be cured. For example, almost 90 percent of children with acute lymphocytic leukemia are cured.
According to SEER data from 2008 to 2014, the five-year relative survival rate for leukemia is 61.4 percent.
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 SEER data from 2008 to 2014, the five-year relative survival rates for Hodgkin’s lymphoma are:
According to SEER data from 2008 to 2014, the five-year relative survival rates for non-Hodgkin’s lymphoma are:
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 doctor:
- the specific type and stage of cancer
- the goals of your treatment options
- 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 all your treatment options. Open communication with your doctor will help you make the best decision for your treatment.