Our Centre provides state-of-the-art services in
haematology and haematological oncology. Our
Haematopathology Laboratory has a wide range of
diagnostic tests available which 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.
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.
Plasma Cell Myeloma
Lymphocytes may mature into plasma cells, which
produce antibodies that fight infection. When
transformed, it 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.
Common Subtypes
- Plasma Cell Myeloma
- Plasmacytoma
- Light Chain Disease
- Non-Secretory Myeloma
- Amyloidosis
Clinical Presentations
- More common among the elderly
- Bone pain
- Bone fracture
- Anaemia
- Kidney failure
- Infections
- High blood calcium
- Bleeding tendency
Diagnosis
- Presence of paraprotein in blood
- Bone X-ray or bone MRI showing abnormal bone
changes
- Bone marrow or tumour biopsy showing abnormal
plasma cells in bone marrow
- Examination of kidney function and blood calcium level
Treatment
- Various combinations of chemotherapy
- Bortezomib (Velcade)
- Thalidomide or Lenalidomide
- Dexamethasone or Prednisolone
- Cyclophosphamide or Melphalan
- Young patients may benefit from autologous or
allogeneic bone marrow transplantation
Prognosis
Survival has improved to a great extent in recent years
because of the availability of many new effective drugs.
Common Treatment
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. Damages
to the normal cells are responsible for the 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 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 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.