Hematology

What is hematology?

Hematology is a branch of medicine that studies the blood and the organs that help create blood. Hematologists, doctors who specialize in hematology, study blood cells, blood vessels, platelets, the lymph nodes, bone marrow, the spleen and the proteins that are involved in bleeding and clotting.

Hematology and oncology are often studied together. But patients often have issues with the blood that aren’t related to cancer at all and need the hematologic services California Cancer Associates for Research and Excellence (cCARE) offers. Hematology issues include:

  • Clotting disorders
  • Bleeding disorders
  • Anemia
  • Low platelet counts.

Blood clotting disorders

When the body is injured and bleeding, the platelet blood cells stick together and form a clot in order to stop the bleeding. If a wound occurs on the outside of the body, such as on the knee, the platelets form a hard scab that is the body’s natural way of keeping germs from entering through the wound.

When the blood clots inside the body without injury, it can block the passage of blood to the heart, lungs and limbs, which can result in heart attack, stroke, loss of a limb or death.

Clotting disorders can be inherited through family genetics, acquired by disease, caused by medications or trauma, or be a symptom of other medical complications such as obesity.

Hematologists often treat clotting disorders with an oral blood thinning medication. The blood thinning medication, called an anticoagulant, reduces the blood’s ability to clot properly.

If used in excess, the lack of clotting could cause other serious medical conditions. Clotting medication is prescribed differently for each patient depending on the condition, severity and personal and family history.

Hemochromatosis (absorbing too much iron)

Hemochromatosis is a disorder that causes the body to absorb too much iron through the digestive tract. Normally, iron helps the body’s hemoglobin within the blood cells carry oxygen to tissues and organs. When the body absorbs too much, it stores the excess iron in the organs and joints. This can cause damage to the point where the joints or organs may fail. While this disorder is present at birth, it may not be diagnosed for many years.

Symptoms and signs of hemochromatosis

  • Darkening of the skin.
  • Joint pain.
  • Abdominal pain.
  • Fatigue and weight loss.
  • Diabetes.
  • Loss of sex drive and impotence.
  • Heart or liver failure.

While hemochromatosis may be a genetic disorder, an important part of managing this condition is controlling the intake amount of iron-heavy food, and thus absorption by the body. Examples of food that contain a large amount of iron include liver and organ meats, black beans, sardines, spinach, olives, pumpkin seeds and tofu.

Hematologists have multiple options to treat this disorder, including:

  • Medication.
  • Phlebotomy – opening or puncturing a vein to withdraw blood.
  • Chelation therapy – circulating a solution through a vein to clear the bloodstream (recommended in place of medication or phlebotomy for people who suffer from heart disease, poor venous access or anemia).

Polycythemia (high red blood cell count)

Polycythemia is a condition that causes an increased level of red blood cells (hematocrit) and hemoglobin in the blood. Polycythemia can be inherited through a genetic mutation, or can be caused by another underlying medical condition that affects the red blood cells such as sleep apnea, tumors, smoking, high altitudes and more.

Symptoms of polycythemia

  • Itching, especially after a shower or bath.
  • Redness of the palms and soles.
  • Fatigue and weakness.
  • Headache and dizziness.
  • Joint pain.
  • Bleeding or clotting problems.
  • Shortness of breath.
  • Severe cough.

A hematologist treats this condition with the help of medication or phlebotomies (drawing blood).

Polycythemia vera (a type of blood cancer)

Polycythemia vera is a rare version of this condition that impacts bone marrow. Polycythemia vera can cause the bone marrow to produce too many red blood cells, and may also result in an overproduction of white blood cells and platelets.

The symptoms of polycythemia vera include trouble breathing when lying down, red skin coloring, a full feeling in the upper-left abdomen and dizziness. The treatment for this specific type of this condition is phlebotomy (drawing blood).

Bleeding disorders

A variety of bleeding disorders can occur when the body has difficulty with blood clotting. These disorders can lead to heavy and prolonged bleeding with an injury. Bleeding may also begin with no apparent cause. These issues can range from mild to severe.

Bleeding disorders may be inherited through family genetics, present at birth, developed from certain illnesses, or caused by use of anticoagulants and antibiotics. Some bleeding disorders include hemophilia A and B, acquired platelet function defects, congenital platelet function defects and several others.

Anemia (low red blood cell count)

Anemia is a common blood condition that affects more than 3.5 million Americans. Anemia occurs when the amount of red blood cells in the blood is too low. The red blood cells carry oxygen from the lungs to the rest of the body. Oxygen helps each organ function properly and gives the body energy.

Symptoms of anemia

  • Fatigue.
  • Paleness.
  • Shortness of breath.
  • Dizziness.
  • Rapid heartbeat.

Anemia can be caused by a number of conditions including iron deficiency, vitamin deficiency, sickle cell disease, which is an inherited disorder, or when diseases of the bone marrow affect the production of red blood cells.

Low platelet count

Also known as thrombocytopenia (platelets are called thrombocytes), low platelet count means there are too few platelets, the colorless type of blood cell, to adequately cause clotting to stop or slow bleeding. This often occurs as a result of another disease such as cancer, immune system problems, the cancer treatments radiation and chemotherapy that can damage stem cells that help produce platelets, and other causes and conditions. Low platelet count can also be an inherited condition.

Low platelet count generally occurs due to one of three factors: bone marrow doesn’t make enough platelets; the body uses or destroys platelets; or the spleen holds on to platelets rather than releasing them into the body.

Treatments depend on the individual situation, and some patients with low platelet count do not require medical intervention. Treatment options include medications, blood transfusions and removal of the spleen.

Hematology services at cCARE

Patients referred to cCARE for hematology services can expect excellent care including gentle blood draws, quick and accurate lab work, and a caring and compassionate environment.

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