The most common blood cancers in aging populations include several types of leukemia, lymphoma, and multiple myeloma. These cancers primarily affect the blood, bone marrow, and lymphatic system, and their incidence increases significantly with age, especially in people over 60 years old.
**Leukemia** is a broad category of blood cancers that originate in the bone marrow, where blood cells are produced. Among leukemias, **acute myeloid leukemia (AML)** is particularly common in older adults, with a median diagnosis age between 63 and 71 years in many developed countries. AML is characterized by the rapid growth of abnormal myeloid cells that crowd out normal blood cells, leading to symptoms like fatigue, easy bruising, infections, and shortness of breath. It progresses quickly and can be fatal within weeks or months if untreated. Risk factors for AML include aging, previous chemotherapy or radiation, smoking, and exposure to certain chemicals like benzene. Treatment usually involves chemotherapy aimed at remission, sometimes followed by stem cell transplantation, but outcomes vary depending on genetic mutations in the cancer cells.
**Chronic leukemias**, such as chronic lymphocytic leukemia (CLL), are also common in older adults. CLL typically progresses more slowly than AML and often affects B-cell lymphocytes. It is one of the most frequent leukemias in the elderly, often diagnosed around the age of 70. Patients may live many years with CLL, sometimes without needing immediate treatment, but it can eventually impair immune function and blood cell production.
**Lymphomas** are cancers of the lymphatic system, which includes lymph nodes, spleen, and other immune tissues. The two main categories are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Among NHLs, **diffuse large B-cell lymphoma (DLBCL)** is the most common subtype in older adults, with an average diagnosis age around 64. DLBCL is aggressive but often responds well to treatment, with many patients achieving remission. Another common NHL subtype in the elderly is **follicular lymphoma**, which tends to grow slowly and is rarely curable but manageable for years. Follicular lymphoma often involves multiple lymph node regions and can affect bone marrow.
**Multiple myeloma** is a cancer of plasma cells, a type of white blood cell responsible for producing antibodies. It is more prevalent in older adults, typically diagnosed in people over 65. Multiple myeloma causes abnormal plasma cells to accumulate in the bone marrow, leading to bone pain, fractures, anemia, kidney problems, and increased infections. While there is no cure, treatments such as chemotherapy, immunotherapy, and stem cell transplants can control the disease and improve quality of life. Treatment in elderly patients requires careful adjustment due to other health conditions and tolerance to therapy.
Aging itself is a significant risk factor for these blood cancers due to the accumulation of genetic mutations in blood-forming cells over time and changes in the immune system. Additionally, clonal hematopoiesis—a condition where certain blood cell clones with mutations expand—has been linked to aging and increased risk of blood cancers and cardiovascular disease.
In summary, the most common blood cancers in aging populations are acute myeloid leukemia, chronic lymphocytic leukemia, diffuse large B-cell lymphoma, follicular lymphoma, and multiple myeloma. These diseases vary in their aggressiveness, symptoms, and treatment options but share a higher incidence in older adults, often requiring tailored approaches to management based on the patient’s overall health and specific disease characteristics.
