Blood Cancer

Our Haematology and Cellular Therapy Centres in Happy Valley and A Kung Ngam provide state-of-the-art services in haematology and haematological oncology. The Centres are also equipped with a Haematopathology Laboratory with a wide range of diagnostic tests that are essential for modern management of haematology patients. After making an accurate diagnosis, optimal treatments are given promptly to obtain the best clinical outcome possible. Treatment options include chemotherapy, radiotherapy, targeted therapy, immunotherapy, bone marrow transplantation and CAR-T therapy. 

Blood cancers are one of the top ten cancers in Hong Kong. Every year, over 1,000 new cases are diagnosed. They include leukaemia, lymphoma and myeloma. 

Leukaemia
Leukaemia is the malignancy of white cells. Its causes are largely unknown. It is occasionally related to previous chemotherapy or radiation exposure, and may be preceded by myelodysplastic syndrome or myeloproliferative disease.

Lymphoma
Lymphoma is the cancer of lymphoid cells, whose causes remain unknown. Some cases may be related to infections, chemicals, radiation or immunodeficiency. 

Plasma Cell Myeloma
Lymphocytes may mature into plasma cells, which produce antibodies that fight infection. When transformed, this leads to malignancy of plasma cells, which is called plasma cell myeloma or plasmacytoma. While the causes remain unknown, the transformation may be preceded by a condition called “Monoclonal Gammopathy of Undetermined Significance (MGUS)”. A small percentage of the elderly population have MGUS. 

Chemotherapy
Most blood cancer patients respond very well to various combinations of chemotherapy. Chemotherapy drugs are effective in eradicating rapidly proliferating cells. As blood cancer cells often grow at a very high rate, they are more susceptible to the effects of chemotherapy. Some normal cells in our body also grow rapidly, e.g. the bone marrow cells. Damage to the normal cells is responsible for any side effects, and thus patients must be monitored closely. Serious infections may complicate low white cell count and bleeding tendency if the platelet counts are low. There may also be anaemia. Haematopoietic growth factor G-CSF (granulocyte colony stimulating factor) may be used. Red cells and platelet transfusions may be given. Chemotherapy may be given in our Chemotherapy Centre on either an outpatient or inpatient basis, depending on the intensity of the therapy. 

Radiotherapy
High-energy radiation is commonly used in cancer treatment. Blood cancer cells are very sensitive to radiotherapy, making it an effective treatment for local control of blood cancers and an adjunct to chemotherapy. 

Targeted Therapy
The transformation of normal cells to cancer cells is the result of many genetic changes. These changes distinguish cancer cells from normal cells and can be used as a target for therapy. Either a monoclonal antibody or a chemical can be used against the target to inhibit its effects. Mabthera/Rituximab is a monoclonal antibody commonly used to treat all kinds of B cell lymphomas, while Imatinib is a chemical drug which is very effective in treating chronic myeloid leukaemia. 

Bone Marrow Transplantation
Bone marrow transplantation is commonly used in treating various types of blood cancers. It is often the last hope for patients. There are two main types of bone marrow transplantation, i.e. autologous transplant using the patient’s own marrow cells, and allogeneic transplant using marrow from HLA (human leukocyte antigens) compatible donors, who can be a sibling or an unrelated donor. The source of the marrow cells or haematopoietic stem cells can be the marrow itself of G-CSF-driven peripheral blood stem cell or cord blood. A mini transplant can also be used for elderly patients to minimise the risk. 

Chimeric Antigen Receptor Therapy (CAR-T) 
CAR-T is indicated for the treatment of i) paediatric and young adult patients up to 25 years of age with B-cell acute lymphoblastic leukaemia that is refractory, in relapse post-transplant or in second or later relapse and; ii) adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after two or more lines of systemic therapy.