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Explore Biomarker Testing

Blood Cancer

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Every blood cancer is different. Biomarker tests help show how.

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Blood cancers can begin in your bone marrow (where blood cells are made), or lymphatic system — with subtypes like multiple myeloma (MM), lymphoma, and leukemia that each respond to unique forms of treatment. This is where biomarker testing comes in.

It helps doctors move from one-size-fits-all care to personalized treatment plans, like targeted therapy — a type of cancer treatment that targets the ways cancer cells grow, divide, and spread. Even if you get tested and don’t have any biomarkers, that’s ok. It’s still important for getting your care team more informed and can help them evaluate treatment options.
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Did you know?

Your treatment plan can be based on your biomarkers.

You may recognize some of these biomarkers from your own chart. There are many biomarkers for blood cancer. Talk to your doctor about testing to see what they may mean.

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About biomarker testing

What are blood cancer biomarkers?

Cancer biomarkers are small signals in tumor cells, like gene changes or certain levels of proteins, that can show how your cancer behaves and how it may change, grow, or respond to treatment. Even two people with the same type of blood cancer can have very different biomarkers.

By testing for them, your care team can create an individualized treatment plan — and adjust it if the disease changes over time. Common blood cancer biomarkers doctors look for are CD20 and CD30 (lymphoma), M-Proteins (myeloma), and FLT3 (leukemia).

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Here’s how they’re tested.

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Liquid Biopsies
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Tissue Biopsies
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Liquid Biopsies

Your care team can learn a lot about your blood cancer by taking a sample of your blood to spot cell count, gene, and protein markers.

For example, a complete blood count (CBC) measures the number and shape of your blood cells, platelets, hemoglobin, and hematocrit to show how changes — especially in white blood cells — may be signs of progressing or new cancer.

Since liquid biopsies are less invasive, they’re faster to complete and easier to repeat than tissue biopsies — but they have their limits. The results may not always match tissue tests and may miss some cancer changes.

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Tissue Biopsies

A tissue biopsy can reveal your blood cancer’s stage, subtype, and cellular changes from a sample of your bone marrow’s tumor.

To do this, your doctor will surgically collect small pieces of marrow from inside your bone, and share them with a pathologist who will examine the marrow cells in a lab.

They’ll measure how much your cancer has progressed, if the tumor in your bone marrow is growing, and share any cell abnormalities, or non-inherited gene and protein changes. This process can help point to targeted therapies, and assess if immunotherapy may work for you.

Tissue biopsies are usually an outpatient procedure and do not require an overnight stay, however there are more invasive tissue biopsies that may require a hospital visit.

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Talk to your doctor

Your tailored treatment plan really begins with a conversation.

When it comes to treating your blood cancer, asking about biomarker testing early can make a big impact on your care. Even if this process is unfamiliar, your doctor can help you understand your options and move forward with clarity.

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Still have questions?

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What biomarkers do doctors look for in blood cancers?

Blood cancer biomarkers differ based on the type of cancer you have. For multiple myeloma, the most common biomarkers are monoclonal protein (M spike) and serum free light chains (SFLC).

For leukemia, CD (cluster of differentiation) markers like CD13, CD33, CD5 and CD23 are most common, along with NPM1 and FLT3 — but there are other important biomarkers your doctor may test for as well.

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Where do I go to get tested?

Where you begin biomarker testing will depend on your need for a liquid biopsy or tissue biopsy.

With blood cancer, liquid biopsies are done with a simple blood draw in a clinic or doctor’s office before samples are sent to a specialized lab for deeper evaluation. It’s also recommended for pediatric patients who are more easily tested with a less invasive blood sample.

However, tissue biopsies — taken from bone marrow — are more invasive, and are performed by collecting small pieces of bone marrow.

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What should I understand about my test results?

When you get your test results, your doctor will go over them with you to help you understand what they mean and how they can be used to determine your treatment options. You’ll most likely discuss:

  • What biomarkers were found — or if no biomarkers showed up
  • What treatment options match those specific biomarkers, and which ones may be available to you
  • If there aren’t treatment matches — what potential clinical trials may be available for those biomarkers, or other treatment options
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Will I need to get retested?

Depending on how well your current treatment is working, your doctor may want to have you retested for any changes to your disease and the biomarkers that may show up.

Since changes can occur over time, it can reveal the way your tumor is growing or changing, or if it’s developing a resistance to treatment.

New biomarkers can indicate alternative treatment options that may work more effectively.

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Are there communities and advocacy groups I can join?

There are many patient advocacy and support groups in the blood cancer community. Here are a couple to get you started with connecting to other patients and caregivers, as well as resources to support you during your journey:

https://bloodcancerunited.org/

https://lymphoma.org