Leukaemia, Lymphoma, Multiple Myeloma, MDS — treated by a CMC Vellore and JIPMER trained Haematologist with 14+ years of dedicated blood cancer experience. At CION Cancer Clinics, Banjara Hills, Hyderabad.
Blood cancer is not one disease. It's a group of cancers with very different biology, treatment and outcomes. The first step is getting the right diagnosis from a haematologist — not a general oncologist.
Cancers of the blood and bone marrow
Leukaemia arises when the bone marrow produces abnormal blood cells that crowd out normal cells. Acute leukaemias — ALL and AML — progress rapidly and require prompt treatment. Chronic leukaemias — CLL and CML — progress slowly and in many cases can be managed with oral targeted agents for years.
CML is now one of the great success stories of targeted therapy — imatinib and second-generation TKIs have transformed CML from a disease requiring urgent transplant to a manageable chronic condition for most patients. AML remains challenging — the choice of protocol depends on cytogenetics, molecular markers and patient fitness.
I review every leukaemia case with bone marrow biopsy results, flow cytometry and cytogenetics before recommending a protocol. The subtype determines everything. Don't start treatment without knowing the subtype.
Cancers of the lymphatic system
Lymphoma is cancer of the lymph nodes and lymphatic system. Hodgkin lymphoma — often presenting with swollen lymph nodes, night sweats and weight loss in young adults — has one of the best cure rates of any cancer when treated with the right protocol.
Non-Hodgkin lymphoma is a larger, more diverse group. Aggressive subtypes like diffuse large B-cell lymphoma (DLBCL) require prompt, intensive treatment. Indolent subtypes like follicular lymphoma may be managed with watchful waiting in early stages. Immunotherapy — rituximab and newer agents — has transformed NHL outcomes significantly.
If you have swollen lymph nodes that don't resolve in 4–6 weeks, don't wait. A haematologist can order the right tests quickly.
Cancer of plasma cells in the bone marrow
Multiple myeloma is a cancer of plasma cells — the antibody-producing cells in the bone marrow. It typically presents with bone pain, anaemia, kidney problems and elevated calcium. The protein electrophoresis (SPEP) is often the first test that raises suspicion.
Treatment has changed dramatically in the last decade. Proteasome inhibitors (bortezomib, carfilzomib), IMiDs (lenalidomide, pomalidomide) and monoclonal antibodies like daratumumab are used in combinations that achieve deep remissions. Autologous BMT remains part of standard therapy for eligible younger patients.
Myeloma is not yet curable for most patients — but for many it has become a manageable chronic condition with modern treatment. Median survival has improved from 3–4 years to well over 7–10 years in the last decade.
Bone marrow failure conditions
MDS is a group of bone marrow disorders where the marrow produces too few normal blood cells, and those it produces are abnormal. It primarily affects older adults and can range from a slowly progressing condition to a pre-leukaemic state requiring urgent intervention.
Risk stratification with IPSS-R scoring guides management. Low-risk MDS may be managed with supportive care, EPO or lenalidomide. Higher-risk MDS often requires azacitidine (hypomethylating agent therapy) and in appropriate patients, allogeneic bone marrow transplant.
MDS is underdiagnosed in India — many patients are treated for "refractory anaemia" for months without the bone marrow biopsy that would give them the correct diagnosis. If your anaemia isn't responding to iron or B12, you need a haematologist.
Modern blood cancer treatment goes far beyond chemotherapy alone. Dr. Basudev uses the most current evidence-based protocols at CION Cancer Clinics.
Still the foundation for most acute leukaemias and aggressive lymphomas. Modern protocols have improved significantly — better supportive care, anti-emetics and growth factors make chemotherapy more tolerable than it was a decade ago. The protocol is specific to the cancer subtype and patient fitness.
Tyrosine kinase inhibitors for CML (imatinib, dasatinib, nilotinib), venetoclax for CLL and AML — targeted oral drugs that specifically block cancer cell survival signals. Many patients take these daily with minimal disruption to normal life, achieving long-term disease control.
Monoclonal antibodies (rituximab, daratumumab, blinatumomab), checkpoint inhibitors (pembrolizumab in Hodgkin lymphoma) and emerging CAR-T pathways. Immunotherapy is now integrated into standard first-line and relapsed protocols for several blood cancers.
For patients where chemotherapy alone is insufficient — or for curative intent in selected cases — BMT (autologous or allogeneic) is the next step. Dr. Basudev manages the complete BMT pathway at CION Cancer Clinics. Learn more →
Questions patients and families most often ask about blood cancer diagnosis and treatment.
The early signs of blood cancer can be subtle and are often mistaken for other conditions. Persistent unexplained fatigue and weakness are among the most common. Other warning signs include: unexplained weight loss, night sweats, fever without obvious infection, swollen lymph nodes (painless lumps in the neck, armpit or groin), bone pain especially in the spine or ribs, frequent infections or slow healing, easy bruising or unusual bleeding, and pale or yellowish skin. Many of these symptoms individually are common and non-specific — it's the combination and persistence that matters. If you have several of these lasting more than 4–6 weeks, a haematologist's evaluation is warranted, not just a repeat blood count.
Leukaemia is a cancer that originates in the bone marrow and blood — it's characterised by abnormal white blood cells circulating in the blood. It's typically detected on a blood count. Lymphoma is a cancer of the lymphatic system — lymph nodes, spleen and related organs — and usually presents as painless swollen lymph nodes. Both are blood cancers, but they arise from different cell types and require different treatment approaches. Some haematological conditions have features of both — blurring the boundary. The specific diagnosis requires bone marrow biopsy, flow cytometry and imaging.
Blood cancer diagnosis requires more than just a blood count. A full diagnostic work-up includes: a complete blood count with differential (often the first clue), a peripheral blood smear examined by a haematologist, bone marrow aspiration and biopsy (the most important test — it examines what's happening in the marrow directly), flow cytometry (identifies the exact cell type and markers), cytogenetic testing (chromosomal analysis — often determines treatment choice and prognosis), and molecular testing (mutations like BCR-ABL for CML, FLT3 for AML). This process takes several days to a week for complete results. I review all of these together before making a treatment recommendation — not just the blood count.
Yes — and outcomes have improved significantly in the last decade. CML in adults is now managed with daily oral targeted therapy, and most patients achieve deep molecular remission with near-normal life expectancy. CLL is often monitored without treatment initially and managed with highly effective oral agents when treatment is needed. AML is more challenging — remission is achievable in many patients but long-term outcomes depend on cytogenetics and whether the patient can undergo BMT. ALL in adults has historically had worse outcomes than in children, but newer protocols including immunotherapy have improved this significantly. The specific type of leukaemia and the patient's age and fitness determine the realistic outcome.
Hodgkin lymphoma is curable in the majority of patients — cure rates above 80–85% with standard ABVD or similar protocols, and even higher with modern PET-adapted therapy. Many aggressive non-Hodgkin lymphomas, including diffuse large B-cell lymphoma (DLBCL), have cure rates of 60–70% with R-CHOP chemotherapy. Indolent lymphomas like follicular lymphoma are not typically curable with current therapy but are highly manageable — many patients live 15–20 years with good quality of life. The key is getting the right diagnosis — the specific subtype determines the treatment plan entirely.
Multiple myeloma is a cancer of plasma cells — the bone marrow cells that produce antibodies. It typically causes bone pain, anaemia, kidney problems and elevated calcium. It is not yet curable for most patients, but modern treatment — proteasome inhibitors, IMiDs, monoclonal antibodies and autologous BMT — has dramatically extended survival. Median survival has improved from under 4 years to well over 7–10 years in the last decade for many patient groups. Some younger patients achieving deep molecular remission with current therapy may be approaching functional cure, though this is still being studied. Treatment has made myeloma a manageable chronic disease for many patients.
Blood cancer treatment costs vary enormously by type. CML treatment with oral imatinib (generic) can be as affordable as ₹2,000–5,000 per month — a dramatic change from when the drug first launched. CLL with ibrutinib or acalabrutinib is more expensive — though insurance coverage is increasingly available. Acute leukaemia induction chemotherapy involves hospitalisation and typically costs ₹1.5–3 lakh per cycle depending on the regimen and centre. Lymphoma treatment (R-CHOP or similar) typically costs ₹80,000–1.5 lakh per cycle. Most health insurance policies in India cover blood cancer treatment as a critical illness. At CION Cancer Clinics, our team explains the complete cost structure before treatment begins. I know this conversation matters. We don't avoid it.
Most blood cancer treatment — including chemotherapy, targeted therapy, immunotherapy and standard monitoring — can be done in Hyderabad at CION Cancer Clinics with a trained haematologist. The major specialist centres in Mumbai (Tata Memorial) and Chennai (Apollo, CMC Vellore for complex cases) have advantages for very rare subtypes, clinical trials, and some specific BMT procedures. But for the vast majority of leukaemia, lymphoma and myeloma patients, the treatment protocol is the same regardless of city — what matters is the haematologist's training and the quality of the centre's supportive care. Dr. Basudev's training at CMC Vellore and JIPMER is as rigorous as any centre in India.
MDS is a group of bone marrow disorders where the marrow produces too few normal blood cells, and the cells it does produce are abnormal (dysplastic). It primarily affects adults over 65, though it can occur at any age. Symptoms include fatigue from anaemia, increased infection risk from low white cells, and bleeding from low platelets. MDS exists on a spectrum — some forms are slowly progressive and may not need immediate treatment; others are high-risk and can transform to acute leukaemia without prompt intervention. Diagnosis requires a bone marrow biopsy with cytogenetics. Many MDS patients in India are misdiagnosed as having simple anaemia for months. If your anaemia is not responding to supplements, ask your doctor about a haematology referral.
A bone marrow biopsy involves taking a small sample of bone marrow — usually from the back of the hip (posterior iliac crest) — to examine the cells being produced there. It's done under local anaesthesia as a procedure that takes about 15–20 minutes. Most patients feel pressure and a brief moment of sharp discomfort when the sample is taken — not prolonged pain. The area may be sore for 1–2 days afterwards. The biopsy is essential for diagnosing leukaemia, lymphoma, myeloma, aplastic anaemia and MDS — no blood test alone can replace it. Most patients are surprised by how manageable it is compared to what they'd feared.
A routine complete blood count (CBC) can raise suspicion for blood cancer — very high or very low white cell counts, anaemia, or low platelets might prompt further investigation. But a blood count alone cannot diagnose or rule out blood cancer. Leukaemia can sometimes be present with a normal blood count in early stages. Lymphoma often doesn't show abnormalities on a blood count until advanced. Myeloma requires specific tests — protein electrophoresis, free light chains, urine Bence-Jones protein — that aren't part of routine panels. If you're concerned about blood cancer, ask for a haematologist's assessment — not just a repeat blood test.
Dr. Basudev Pokhrel is a Consultant Haematologist at CION Cancer Clinics, Hyderabad, experienced in treating both Hodgkin and non-Hodgkin lymphoma. He is trained at CMC Vellore (Post-Doctoral Fellowship) and JIPMER (MD), with 14+ years of haematology practice. Available at ANR Centre, Banjara Hills, Hyderabad — Monday to Saturday, 10 AM to 5 PM. Contact +91 9063490160.
Bring your existing reports — blood counts, biopsy results, previous treatment records. Dr. Basudev will review everything at the first consultation.