Hematology is the study of blood and the treatment and prevention of diseases affecting this vital fluid. Doctors working in the field manage patients with blood diseases and disorders, either by providing direct care or working in a laboratory, where they analyze smears and slides of blood and bone marrow for diagnoses.
Blood has multiple components, some of the most important being plasma, red blood cells, white blood cells, and platelets.
Monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma are two hematology-related disorders. MGUS is milder and, in one percent of cases, a precursor to multiple myeloma. Multiple myeloma causes plasma cells to produce abnormal immunoglobulins with a band or a spike. They accumulate in the bone marrow, crowding out healthy cells. This can result in anemia, bone pain, frequent infections, and reduced kidney function.
Anemia is one of the most common red blood cell disorders, and it occurs when there are not enough of these cells in the blood. Hemoglobinopathy is a group of inherited conditions affecting the structure and production of hemoglobin, including sickle cell anemia. Enzymopathies are genetic disorders that affect the enzymes in red blood cells, leading to a specific form of anemia.
White blood cell disorders occur when there are too many or not enough of these immune system cells. A decrease in the number of white blood cells is leukopenia. People with this disorder are prone to infection. Leukocytosis occurs when there are too many white blood cells. This can result from the body's normal response to infection but can also be a symptom of leukemia and other cancers. There are multiple types of white blood cells, but these disorders most often affect lymphocytes and neutrophils.
Platelet disorders involve an increase or decrease in platelets. Thrombocythemia and thrombocytosis are caused by an overproduction of these blood cells. Thrombocytopenia occurs when there are not enough platelets in the blood. There are many causes, including certain medications, pregnancy, bone marrow suppression, immune disorders, and systemic infections. Platelet dysfunction can also occur as a result of an inherited or acquired defect or an outside factor that changes the function of normal platelets.
There are two fields of study in hematology. A hematologist focuses on direct patient care by diagnosing and treating blood disorders. A hematopathologist studies diseases of the blood and bone marrow and other parts of the body that affect them, including the spleen, lymph nodes, and thymus. These specialists diagnose conditions, usually from directly examining blood and tissue samples in the lab. Hematologists and hematopathologists often work together to ensure that patients receive a proper diagnosis and appropriate care.
Common blood tests include a complete blood count, which measures the number of white blood cells, red blood cells, and platelets in the blood; hematocrit, which measures the volume of red blood cells; and hemoglobin, which measures the oxygen-carrying capacity of the blood. Differential white blood cell counts, platelet counts, and clotting times are also important tests.
Hemopathology also uses some specialized tests to detect various conditions and learn more about them, facilitating treatment. These include metabolic hematology tests to identify abnormalities like sickle cell disease and enzyme deficiencies, molecular analysis to qualify RNA and DNA abnormalities, and special coagulation tests to determine the abnormalities causing certain bleeding disorders.
Treatments for hematology diseases are vast and depend on the diagnosis. Some of the most common include targeted drug therapy, biological cancer therapy, blood transfusions, bone marrow transplants, immunosuppressive therapies, immunotherapy, and growth factor drugs. Healthy people are encouraged to donate blood or bone marrow stem cells to help treat patients with these disorders.
Researchers are currently exploring the use of blood components in the treatment and possible curing of cancer. Virotherapy is an emerging field in hematology that focuses on programming viruses to replicate and destroy cancer cells. Recent research has uncovered promising results. Checkpoint blockades have also emerged as an area of interest and may help restore the blood's ability to fight off tumors.
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