What Is Bone Marrow Cancer?

Medically reviewed by Doru Paul, MD

Bone marrow cancer is a group of cancers that develop in the blood cells of your bone marrow. The bone marrow is the spongey material inside the bones where stem cells develop into blood cells including the red blood cells, white blood cells, and platelets. While these two conditions often get confused with one another, bone marrow cancer is not the same as bone cancer.

When bone marrow cancer develops, the cells in the bone marrow begin to grow and multiply at an out-of-control rate. The main types of bone marrow cancer include leukemia, multiple myeloma, lymphoma, myelodysplastic syndromes, and myeloproliferative neoplasms. Symptoms of this cancer can vary by the type of cancer but may include fatigue, pain, and unintended weight loss.

An oncologist (a doctor who specializes in treating cancer) and a hematologist (a doctor who specializes in treating blood disorders) often work together to treat bone marrow cancer. Treatment options for bone marrow cancer include chemotherapy, radiation therapy, immunotherapy, targeted therapy, and stem cell transplantation. 

Types of Bone Marrow Cancer

There are different types of bone marrow cancer, and they each affect different blood cells. Most blood cells start in the bone marrow as stem cells. They then develop into mature blood cells that have several functions in the body. White blood cells are part of the immune system and fight infection. Red blood cells transport oxygen throughout the body. Platelets clot the blood and prevent bleeding.

Leukemia

Leukemia is a type of cancer that affects the white blood cells. In people with leukemia, the bone marrow produces abnormal white blood cells that do not die off at a normal rate. These leukemia cells build up and start to crowd out the normal white blood cells, red blood cells, and platelets.

Common types of leukemia include:

• Acute myeloid leukemia: Affects the immature blood cells (blasts), causes symptoms to progress quickly, and occurs in both children and adults

• Acute lymphocytic leukemia: Affects the immature blood cells (blasts), causes symptoms progress quickly, and occurs in both children and adults

• Chronic myeloid leukemia: Affects the mature blood cells, causes symptoms that are usually mild for years, and occurs mostly in adults

• Chronic lymphocytic leukemia: Affects the mature blood cells, causes symptoms that are usually mild for years, and occurs in adults 
  

Multiple Myeloma

Multiple myeloma occurs when the bone marrow produces too many plasma cells. Plasma cells are immature cells that are sent out to other areas of the body to develop. Some plasma cells produce antibodies, which are proteins that help your body to fight infection.

When your body develops too many plasma cells, they are referred to as myeloma cells. These myeloma cells build up in the bones and form tumors. Over time, this leads to bone loss and increases the risk of infection. 

Lymphoma

Lymphoma is a type of cancer that occurs when lymphocyte cells grow and multiply at an out-of-control rate. The lymphocytes are part of the immune system and are located in the lymphatic system. Lymphoma can develop in any area of lymphatic tissue or lymph nodes and may spread to the bone marrow.

Types of lymphoma include:

• Hodgkin lymphoma: Starts in B lymphocytes

• Non-Hodgkin lymphoma: Starts in B or T lymphocytes

Myeloproliferative Neoplasms

Myeloproliferative neoplasms (MPNs) are a group of bone marrow cancers that affect the stem cells. When the bone marrow produces too many immature stem cells, they affect the production of white blood cells, red blood cells, and platelets. These cancers usually worsen as the bone marrow produces more and more stem cells.

Types of myeloproliferative neoplasms include:

• Essential thrombocytopenia: Too many platelets, which may lead to blood clots (thrombi)

• Myelofibrosis: Abnormal blood cells and fibers that build up in the bone marrow

• Polycythemia vera (PV): Too many red blood cells, but may also affect levels of white blood cells and platelets
  

Myelodysplastic Syndromes

Myelodysplastic syndromes are a group of conditions that occur when the cells in the bone marrow that make blood cells become abnormal and start growing and multiplying at an uncontrollable rate. These syndromes can lead to too many or too few white blood cells, red blood cells, or platelets. These syndromes are considered cancer and may lead to leukemia over time. 

Symptoms

Bone marrow cancer symptoms can vary depending on the type of cancer you have and which blood cells are affected. People with blood or bone marrow cancer usually feel unwell because their blood cells are not performing their normal duties.

General symptoms of most bone marrow cancers may include:

• Fatigue

• Loss of appetite

• Unintended weight loss

• Bone pain

• Night sweats

• Chronic cough

• Swelling

When bone marrow cancer causes low levels of certain blood cells, the symptoms will vary depending on the type of cell affected.

Symptoms of a low white blood cell count (leukopenia) include:

• Fever

• Recurrent infections

Symptoms of a low red blood cell count (anemia) include:

• Shortness of breath

• Dizziness

• Pale complexion

Symptoms of a low platelet count (thrombocytopenia) include:

• Bruising

• Bleeding

• Tiny red dots on the skin (known as petechiae)

• Heavy menstrual periods

• Bleeding gums 
  

Causes

Bone marrow cancer occurs when the stem cells in the bone marrow mutate and begin growing and multiplying at an uncontrollable rate. The abnormal cells then crowd out the healthy ones and prevent the white blood cells, red blood cells, and platelets from functioning normally. The exact cause of bone marrow cancer is often unknown. But, each type of bone marrow cancer has its own risk factors.

Risk factors for bone marrow cancer include a history of radiation exposure, a family history of bone marrow cancer, and smoking tobacco. Being a child or over the age of 50, having an infection like Epstein-Barr virus, or living with a genetic disorder like Down syndrome or neurofibromatosis can all increase your risk of leukemia.

You may be at risk of developing multiple myeloma if you are older in age, were assigned male at birth, have African American ancestry, or live with obesity. While older age also plays a role in your likelihood of developing myeloproliferative neoplasms, males and females are both at an increased risk of this condition. People assigned female at birth are more likely to be diagnosed with essential thrombocytopenia, whereas people assigned male at birth are more likely to receive a diagnosis for polycythemia vera and myelofibrosis.

Diagnosis

There are several tests that healthcare providers can use to diagnose bone marrow cancers. Your healthcare provider will begin with a physical exam and thorough medical history. But, they will use other diagnostic measures to confirm a diagnosis.

Your provider will likely order a series of blood tests, which may include:

• Complete blood count (CBC): Checks the levels of white blood cells, red blood cells, and platelets

• Tumor markers: Detects cancer cells

• Metabolic panel: Evaluates the function of your liver, kidneys, and fluid levels in the body

They can also use these other tests to reach a proper diagnosis:

• Urine test: Determines the protein level in your urine and assesses the kidneys

• Bone marrow biopsy: Look for abnormalities in the bone marrow

• Lymph node biopsy: Analyzes if cancer cells have spread

• Imaging scans: Identifies where your cancer is and how far it has spread

Common Imaging Tests

Your healthcare provider may order a computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, or X-ray to check for bone marrow cancer.

Treatment

Getting a diagnosis for cancer can be scary and worrisome. Your healthcare team is there to provide you with the proper care you need to live with your condition and beat cancer. Your exact treatment plan will depend on your type of cancer, how advanced it is, and your overall health. But, treatment options for most people with bone marrow cancer include:

• Chemotherapy: Systemic drugs that find and destroy fast-growing cancer cells

• Radiation therapy: High-energy beams that target the area where your cancer is growing

• Immunotherapy: Boosts your immune system’s response to cancer cells

• Targeted therapy: Targets and attacks specific types of cancer cells while sparing healthy cells

• Bone marrow transplant (stem cell transplantation): Replaces the damaged bone marrow with healthy donor marrow from another person
  

How to Prevent Bone Marrow Cancer

The exact cause of bone marrow cancer is unknown. It may be possible to lower your risk by avoiding any modifiable risk factors, such as quitting smoking and managing obesity. However, most of the known risk factors are based on things like a family history of cancer, your genetics, and your sex. That said, these factors cannot be changed, so researchers have not found strategies that can eliminate the risk of this condition.

Related Conditions

Having bone marrow cancer raises the risk of developing other types of cancer in the future. For example, a history of multiple myeloma means that you are more likely to develop acute myeloid leukemia and myelodysplastic syndrome.

People who have been diagnosed with leukemia may also develop the following types of cancer in the future:

• Colon cancer

• Kaposi sarcoma

• Lung cancer

• Melanoma

• Oral cancer

• Prostate cancer

• Small intestine cancer

• Soft tissue sarcoma

• Thyroid cancer 
  

Living With Bone Marrow Cancer

Bone marrow cancer is a serious condition that affects just about every area of your life. During and after your treatment period, there will be several healthcare appointments to attend. During appointments, your healthcare team will administer treatment, address any side effects, and monitor you for signs of complications.

The prognosis for bone marrow cancer varies based on the type of bone marrow cancer you have, how advanced it is, and your overall health. Healthcare providers usually consider the 5-year survival rate when determining a person’s prognosis. The 5-year survival rate measures the percentage of people who are still living 5 years after their cancer diagnosis.

Multiple myeloma is usually not curable but can be managed. The 5-year survival rate for multiple myeloma is 77.5% when diagnosed in the early and localized stage. The prognosis for leukemia greatly depends on the type of cancer and age of the person. The 5-year survival rate for acute lymphocytic leukemia (ALL) in children is 90%. The overall 5-year survival rate for leukemia is 66.7%.

To lower your risk of complications or recurrence, experts recommend engaging in health habits such as avoiding smoking, managing obesity, engaging in physical activity regularly, eating a nutritious diet, and limiting alcohol use.

Frequently Asked Questions

What is the average age for bone marrow cancer?

For most bone marrow cancers, the risk goes up as you age. But, certain types of leukemia are more common in children and older adults. 

How quickly does bone marrow cancer spread?

There are different kinds of bone marrow cancer, and they spread at different rates. Acute leukemia tends to spread quickly while chronic leukemia is slow and causes only mild symptoms for the first few years.

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