Hematology
What is Hematology?
The medical specialty that deals with blood (red blood cells, white blood cells, platelets, coagulation proteins, etc.), blood-forming organs (hematopoietic organs: bone marrow, spleen, lymph nodes, etc.) and diseases of these two structures is called hematology. What are Hematological Diseases?
There are many blood diseases (hematological diseases) originating from different blood cells or blood production organs. These diseases can be seen in both adult and pediatric age groups, and some of them are of genetic origin.Some of the blood diseases, which can cause significant problems by changing the number, structure or functions of blood cells, are of sudden onset and have an aggressive course (acute diseases), while others progress more slowly over time (chronic diseases).Some of the common pathological clinical pictures related to blood cells can be summarized as follows:- Anemia (Red blood cell deficiency, anemia)
- Leukopenia (White blood cell deficiency)
- Thrombocytopenia (Platelet deficiency)
- Polycythemia (Red blood cell excess, erythrocytosis)
- Leukocytosis (White blood cell excess)
- Thrombocytosis (Excess platelet)
Major hematological diseases:
1- Erythrocyte/Red blood cell/Red blood cell-derived hematological diseasesAnemia (Anemia)It is a fairly common disease. It most commonly occurs due to the deficiency of iron in the body, which has an important role in the structure of erythrocyte, and is called iron deficiency anemia. The most common hematological disease in the community is iron deficiency anemia. It occurs as a result of another medical problem and the underlying cause should be investigated.However, there are also different types of anemia that can progress more severely. In addition, anemia can occur with other diseases or as a side effect of some drugs.Some types of anemia other than iron deficiency anemia include:Pernicious anemia: It is an autoimmune disease in which vitamin B12 (cobalamin), which is necessary for the normal functioning of blood formation (hematopoiesis), cannot be adequately absorbed.- Sickle cell anemia: Anemia caused by a structural defect caused by a genetic mutation in hemoglobin molecules in red blood cells.
- Aplastic anemia: It is a rare, serious type of bone marrow failure that occurs when the bone marrow cannot make enough new blood cells.
- Autoimmune hemolytic anemia: It is a type of anemia that occurs when red blood cells are destroyed by the body's own immune system.
1-Hematological diseases originating from leukocytes / White blood cells / White blood cells
Leukocytes, which are found throughout the body, including the circulatory system and the lymphatic system, are cells that play an important role in the immune system, which protects the body against microbiological infectious diseases. There are sub-cell types with structural and functional differences: lymphocytes, neutrophils, eosinophils, basophils and monocytes.- Leukemia
- Lymphoma
- Multiple Myeloma
- Myelodysplastic syndrome (MDS)
2- Hematological diseases originating from platelets
- Hemophilia
3- Platelet function disorders
- Von Willebrand's disease
- Primary thrombocytosis
What are the Symptoms of Hematological Diseases?
Symptoms of hematological disorders vary according to the affected blood cell. Common findings in red blood cell disorders, which are responsible for transporting oxygen in the body:oFatigueoPalenessoDifficulty concentrating and learningoHeart palpitations (tachycardia)Common findings in white blood cell disorders in the immune system:oChronic infectionsoFatigueoWeight lossoHeadacheoMood disordersCommon findings in diseases related to thrombocyte involved in blood coagulation:oBruises on the skin, subcutaneous hemorrhagesoPetechiae (tiny red spots under the skin)oSlow-healing wounds and cutsoNosebleedsobleeding gumsoVascular occlusions, strokes (in cases where the platelet count is high) These complaints listed above can also be seen in many non-hematology diseases. In the presence of these findings, the physician may request examinations starting from simple to very complex advanced laboratory examinations in order to evaluate together with the examination findings and to make the differential diagnosis of a hematological disease.Some of these could be:- Simple blood count
- Microscopic examination of blood
- Molecular biological tests
- Flow cytometry
What are the Treatment Options in Hematological Diseases?
Developments in the field of medicine strengthen the hand of physicians in the fight against hematological diseases and ensure that the results obtained from these treatments are more satisfactory.Treatment of hematological diseases can vary greatly depending on the disease and the condition of the patient.Diet and life regulations, iron, B vitamin supplements may be sufficient in some of the anemias. While steroid and oral chemotherapies are necessary in chronic neoplastic diseases, intensive chemotherapy should be applied in lymphomas and multiple myeloma. In some of the diseases, transfusion of blood and blood products, radiotherapy and surgical interventions may be required from time to time. In some cases, bone marrow transplants and genetically modified cell therapies are the most accurate treatment options. What is Bone Marrow Transplantation?
- The “stem cells” found in the bone marrow are responsible for the production of blood cells in the body. In cases where the bone marrow is damaged or lost its function, the reintroduction of new “stem cells” obtained through various means into the body through the vein is called “bone marrow transplant”.
- The person from whom the stem cells are taken is called a donor/donor, and bone marrow transplants are classified according to the donor. Namely;
- Autologous transplant:
- The donor is the patient himself. Stem cells taken from the patient are frozen and transplanted back to him after certain procedures. The aim here is to reset the bone marrow damaged by high-dose chemotherapy and/or radiotherapy to be given for treatment. Multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma and acute myeloid leukemia are among the diseases that autologous transplantation can be performed.
How is Bone Marrow (stem cell) taken? Does the Donor Suffer in Health?
Stem cells are obtained from the donor's bone marrow or peripheral blood via vascular access by minimally invasive methods. Before the procedure, the donor is given a 5-day treatment to ensure that the stem cells are circulated. There is no early or late harm in being a donor for stem cells. In some cases, there may be stiffness and general body fatigue at the treated site for several days. The donor body replaces the stem cells within a few weeks. Post-Transplant Follow-up?
The most important problem in all transplants is the failure of the procedure, that is, the inability of the given stem cells to settle in the bone marrow sufficiently. In this case, the transplant procedure is repeated. Another undesirable situation is the recurrence of the disease despite the marrow transplant. In this case, new treatment protocols are applied.In addition, the reaction of the donor's strong cells against the patient's cells after allogeneic transplants, namely Graft Versus Host Disease (GVHD), is among the important problems and requires serious struggle. This situation can be seen at a rate of 30-40% in relative transplants and 50-60% in non-relative transplants.The patient, who is kept under intensive follow-up in private rooms after the transplant, should also follow routine outpatient follow-up programs after discharge. Previously weekly controls are followed by monthly and annual controls. It may take a period of 6 months to return to normal working life.
Updated date : Eylül 06, 2023
Upload date : Haziran 15, 2023
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Serdar Bedii OMAY
M.D.
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