What is Haematology?
Haematology is a branch of medicine that studies blood disorders. Patients are generally referred to haematologists by General Practitioners (GP) and hospital specialists due to abnormalities found in the red blood cells, white blood cells, platelets, bone marrow, spleen, blood vessels, lymph nodes and/or the proteins that play a crucial role in blood clotting.
Disorders treated under General Haematology
The disorders that are commonly treated under General Haematology include those that occur due to the irregularities found in the blood count:
- Low haemoglobin/red blood cells – Anaemia
- Low platelet count — Thrombocytopenia
- Low white blood cells –Leucopenia, Myelodysplastic Syndrome, leukaemia
- Low red blood cells, white blood cells and platelets – Pancytopenia, Aplastic Anaemia
- Too many red blood cells – Polycythaemia
- Too many white blood cells – Leucocytosis
- Too many platelets — Thrombocytosis
The following disorders are also treated in the practice of General Haematology:
- Clotting disorders – Thrombosis/thrombophilia, coagulopathy
- Bleeding disorders – Haemophilia, clotting factors deficiency
The form of therapy that is used to treat blood-related conditions in General Haematology depends on the type of disorder as well as the severity of it.
In the treatment of Anaemia, where the red blood cell count is low, the form of treatment is dependent on the cause of the disorder.
Iron deficiency – patient is treated with iron supplements in less severe cases or with blood transfusions if the condition has gotten severe.
Vitamin deficiency – one such type is known as Pernicious Anaemia which is treated with Vitamin B-12 injections. Another type is folic acid deficiency anaemia and it is treated with folic acid supplements.
For cases of Aplastic Anaemia where the bone marrow is unable to produce sufficient blood cells and platelets, there are various forms of therapy.
Blood transfusion – Patients may have to undergo blood transfusions to boost their red blood cell or platelet levels.
- Pros: blood transfusions can relieve symptoms and are generally safe.
- Cons: complications may arise from multiple blood transfusions and the body may gradually develop antibodies to blood that has been transfused, reducing their effectiveness.
Stem cell transplant – In more serious cases of Aplastic Anaemia, a stem cell (bone marrow) transplant may be required. The patient receives stem cells from a matching donor, usually a sibling, which move into the bone marrow cavities and begin the process of producing healthy blood cells.
Thrombocytopenia, which is a disorder of the blood platelets, is generally treated by addressing the underlying cause of it.
Low platelet level – Levels may be transiently increased with platelet transfusions.
Irregularities in the immune system (Immune thrombocytopenic purpura) – medications may be prescribed to increase platelet levels. The most commonly used medication in such cases is a corticosteroid.
Severe cases – Other drugs including thrombopoietin agonists or stronger immunosuppressive therapy or spleen removal surgery may be recommended.
In treating Thalassemia, only moderate to severe cases required therapy.
Repeated blood transfusions – patients suffering from severe Thalassemia require blood transfusions every few weeks. This however , may lead to an accumulation of iron in the body after a period of time which is potentially detrimental to certain organs.
Chelation therapy – an injection of chelating agents is administered which allows it to travel into the bloodstream where it binds to certain metals and minerals. These metals or minerals will subsequently be removed from the body. Chelation therapy is used to remove iron from your blood in the treatment of Thalassemia.
Stem cell transplant – a form of treatment that is usually recommended to children with severe Thalassemia. A successful stem cell transplant will mean that the patient will not need to have their condition controlled and treated through lifelong blood transfusions and/or medication.
Leucocytosis is when the white blood cell levels are too high. While the white blood cell count may revert to its normal levels without any additional treatment, Leucocytosis is treated by addressing the causes of this condition.
There are 2 types of Thrombocytosis and treatment varies according to which type the patient has. For Reactive Thrombocytosis, no treatment is required. For the other type of Thrombocytosis, known as Essential Thrombocythaemia, medication that will aid in lowering platelet levels and rendering platelets less ‘sticky’ will be prescribed.
Thrombosis is the formation of a blood clot in a blood vessel that is significant enough to prevent the regular flow of blood. The form of therapy adopted is dependent on the type of Thrombosis:
Deep Vein Thrombosis or pulmonary embolism
Blood thinning medication – anticoagulants, or blood thinners, are drugs that are either taken orally or injected that reduces the body’s blood clotting abilities. While the medication is unable to break up existing blood clots, they stop more blood clots from forming.
Clot busters – in cases of more severe deep vein thrombosis, medication that aids in breaking up blood clots more rapidly may be prescribed. These are called thrombolytics or clot busters.
Filters – for patients who are unable to take blood thinning medication, a filter may be used. This is inserted into the vena cava in the abdomen and prevents clots that have dispersed from getting caught in the lungs.