Leukemia and Hematology Program

Leukemia usually occurs in white blood cells in the bone marrow, often spreading to the blood. There are several types of leukemia:

• Acute lymphoblastic leukemia (ALL)
• Acute myeloid leukemia (AML)
• Chronic lymphocytic leukemia (CLL)
• Chronic myeloid leukemia (CML)

Waldenström's macroglobulinemia (Waldenström's) is a rare white blood cell cancer. It is a slow-growing type of non-Hodgkin lymphoma. Waldenström's mostly forms in the bone marrow and can slow the growth of normal blood cells, which can lead to anemia and a weakened immune system.

Multiple myeloma is a type of cancer in which white blood cells called plasma cells collect in the bone marrow.

Myelodysplastic syndrome is a group of blood cancers that cause immature blood cells to build up in the bone marrow leading to a shortage of mature blood cells. Some people with MDS go on to develop AML.

Myeloproliferative neoplasms are rare blood cancers that cause an overproduction of red blood cells, platelets or white blood cells. MPNs can also turn into AML.

Noncancerous hematologic conditions affect your blood’s ability to function properly. You may have too few or abnormal blood cells, blood clots or excessive bleeding. We treat the full range of rare and common noncancerous blood conditions, including:

• Bleeding disorders, such as hemophilia
• Blood disorders in pregnancy, such as iron deficiency anemia
• Clotting disorders, such as antiphospholipid syndrome (APS)
• Red blood cell disorders, such as sickle cell disease (SCD)
• Platelet disorders, such as thrombocytopenia

Leukemia is the most common form of cancer in children. It affects approximately 3,000 children each year in the United States, accounting for about 30% of childhood cancers. We offer specialized treatment for children with leukemia at Stanford Children’s Health.

Our specialists diagnose blood disorders by examining the blood and bone marrow. Our hematologists and pathologists have specialized training in identifying the many types of blood cancers and disorders. We use the latest diagnostic tools, such as immunophenotyping, which uses antibodies that stick to certain cells to diagnose leukemia and multiple myeloma.

If you already have a diagnosis, our team will review your test results. We may recommend further testing to confirm your diagnosis and determine the next steps for your care.

The tests we use to diagnose leukemia, multiple myeloma, and benign blood disorders include:

Because blood cancers are not solid tumors, medication therapy is often the first treatment choice. Our medical oncologists have deep expertise in treating cancer using various types of oral or intravenous (IV) medications. Your treatment may include a combination of medication therapies with or without radiation therapy.

The types of cancer medications that we use to treat leukemia and multiple myeloma include:

• Chemotherapy, slows or stops the growth of rapidly dividing cancer cells
• Immunotherapy, harnesses your own immune cells to destroy cancer cells
• Targeted therapy, binds to specific molecules on cancer cells and interferes with their growth or functioning

Stanford Medicine researchers are working every day to improve medication therapies for blood cancers. We’re known worldwide for innovations in immunotherapy and targeted therapy. Our work is reshaping what doctors consider standard treatments for blood cancer. 

Radiation therapy uses high-energy X-ray beams to destroy cancer cells. In blood cancers, doctors use external radiation to treat:

• Bones affected by multiple myeloma
• Organs or tissues where cancer has spread beyond the blood and bone marrow 
• The entire body before a bone marrow transplant

People with blood cancers can experience pain in their bones or pain caused by an enlarged spleen, liver, or lymph nodes. Radiation therapy can help reduce pain by destroying cancer cells or shrinking enlarged organs.

Blood and bone marrow transplant is a treatment for people with multiple myeloma, some types of leukemia, and other noncancerous blood disorders.

In a blood and bone marrow transplant, doctors use high doses of chemotherapy, sometimes with radiation, to destroy all bone marrow cells. You then receive replacement blood or bone marrow cells. Replacement cells can come from:

• A matched donor (allogeneic)
• Your own cells collected before high-dose chemotherapy (autologous)

Stanford Health Care has the largest blood and bone marrow transplant program in Northern California. We are also a national leader in transplant clinical trial research, receiving funding from the National Cancer Institute.

Some cancer cells have specific molecules called biomarkers. Our doctors use these biomarkers to choose chemotherapy and targeted therapy treatments that will be most effective. Our experienced cancer geneticists perform biomarker testing and work with your doctor to develop your treatment plan.

Noncancerous blood disorders cause a range of problems in the blood, so treatments vary widely. Depending on the condition, our doctors may use medications and other therapies to:

• Stimulate blood cell production
• Slow the destruction of blood cells
• Thin the blood
• Aid or prevent clotting
• Replace blood cells (transfusion)
• Protect bone marrow cells

As you and your family proceed through diagnosis, treatment, and follow-up care, your challenges and needs will change. That’s why we offer services that go beyond your physical health. Our Circle of Care approach provides emotional and spiritual care and other supports to help you feel your best.