Hematology

Turkey isn’t just the land of ancient wonders and vibrant bazaars, it’s also a shining beacon of medical and technological advancement, especially when it comes to blood health.  From state-of-the-art labs to heartfelt bedside care, Turkey is redefining hematology with a blend of brains, compassion, and no-nonsense results.

Among the many well-known medical facilities in Turkey, Biruni Hospital stands tall as one of the most efficient and highly advanced hospitals, with a key significance when it comes to hematology and its procedures.

What is a hematology procedure?

A hematology procedure refers to any medical test or treatment that mainly focuses on blood and all of its diseases and procedures. The procedure mainly focuses on:

• The blood
• Bone marrow
• Lymphatic system
  

These procedures are used to diagnose, monitor, and treat any blood-related conditions such as:

• Anemia
• Leukemia
• Lymphoma
• Clotting disorders

These procedures include:

• Full diagnostic tests such as complete blood count, bone marrow biopsies, and genetic testing
• Therapies such as chemotherapy, blood transfusions, iron infusions, and stem cell transplants

What are the types of hematology procedures?

Hematology procedures include blood tests like complete blood count (CBC),coagulation tests, and bone marrow biopsies. Other procedures involve blood smears, flow cytometry, and specialized tests to diagnose anemia, leukemia, clotting disorders, and other blood-related conditions.

Bone marrow aspiration and biopsy

This procedure is commonly used to evaluate the function and structure of bone marrow. This is the area of the body where blood cells are made.
This procedure helps in diagnosing conditions such as:

• Leukemia
• Lymphoma
• Aplastic anemia
• Multiple myelomas
• Myelodysplastic syndromes

Step-by-step process:

• Patient preparation: The doctor will ask the patient to lie on their side or stomach, usually over the posterior iliac crest.
• Sterilization and anesthesia: The surgeon begins by sterilizing the skin. After that, a local anesthetic is injected.
• Aspiration: Using a thin needle, the doctor draws liquid marrow. You might feel some pressure or a sharp pain.
• Biopsy: With the use of a thicker needle, the doctor starts to extract a core sample of solid marrow.
• Sample handling: After extracting the necessary samples, the slides are prepared and specimens are sent for cytology.

Hematopoietic stem cell transplant (Bone Marrow Transplant)

This procedure is generally used to replace damaged bone marrow with healthier stem cells. This treatment is commonly used to treat medical problems such as:

• Leukemia
• Lymphoma
• Aplastic anemia
• Thalassemia
• Myeloma

Step-by-step process:

• Eligibility assessment: The doctor will perform a comprehensive evaluation. This will include imaging, labs, and organ function testing.
• Stem cell collection: Samples of stem cells will be harvested from your blood or bone marrow.
• Conditioning regimen: This will come in the form of high-dose chemo and/or radiation to destroy diseased cells and suppress the immune system.
• Transplant infusion: The doctor will infuse the stem cells into the bloodstream through a central line.
• Engraftment monitoring: After the procedure, the doctor will conduct blood tests to track the recovery of white cells, platelets, and red cells.

Flow cytometry

Flow cytometry is a laboratory technique used to analyze the physical and chemical characteristics of cells.

This is done with the use of laser-based technology and fluorescent markers, allowing the doctor to identify all the necessary information about cells such as:

• The type
• The size
• Populations in blood

Step-by-step process:

• Sample collection: The doctor will collect samples from your blood, bone marrow, or lymph nodes.
• Cell preparation: The collected cells are isolated and suspended in fluid.
• Staining: The cells are treated with fluorescent antibodies targeting specific markers.
• Flow cytometry run: The cells pass through lasers one by one to measure light scatter and fluorescence.
• Report generation: A hematopathologist interprets and reports findings, often guiding treatment.

Complete blood count (CBC)

The complete blood count, or CBC, is the most fundamental hematology test used by doctors for its high efficiency. It provides detailed information on red blood cells, white blood cells, and platelets.
This test is usually used to detect:

• Anemia
• Infections
• Clotting disorders
• Leukemias

Step-by-step process:

• Blood collection: Performed by inserting a venipuncture into an EDTA tube to prevent blood clotting.
• Automated analysis: The doctor uses a hematology analyzer to count and measure blood cells.
• WBC differential: Either manual or automated analysis distinguishes between neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
• Flagging abnormalities: If irregular values are detected, the machine will flag them.

How to prepare for a hematology procedure?

To prepare for a hematology procedure, patients may need to fast for a few hours, avoid certain medications, and inform their doctor about any existing health conditions. It's also important to stay well-hydrated and follow all pre-test instructions provided by the medical team.

Personal preparations

• Know your medications
  List all medications and supplements that you are taking. This is very important, as some medications can affect you negatively during the procedure. During your first appointment, consult your doctor to know which medications need to be stopped.
• Fasting
  Prior to the procedure, you must fast for a period of 8–12 hours. Confirm fasting requirements for specific tests or treatments.
• Stay hydrated
  Drinking is important, as it keeps your blood pumping and your body clear. However, do not overdo it. Avoid excessive fluids before procedures such as stem cell collection.
• Stop smoking and alcohol
  Before undergoing the procedure, quit smoking and drinking alcohol for 24–48 hours. These substances can negatively affect your blood and recovery.
• Get mentally prepared
  Mental health is important before any procedure. Surround yourself with supportive people. Consider joining a support group or talking to others who’ve had similar procedures.

Medical preparations (With Your Doctor)

• Medical history and baseline labs
  Your doctor will check your full medical history and assess for any allergies that could impact the procedure. Expect tests like CBC or liver function to assess readiness.
• Imaging and physical assessment
  Your doctor may schedule imaging to help locate biopsy sites. A physical exam ensures there are no complications.
• Logistical planning
   Arrange for someone to drive you to and from the hospital. Confirm your insurance, prepare for a potential hospital stay, and take time off work if needed.
  

The post-operative healing after a hematology procedure

Post-operative healing after a hematology procedure depends on the type of intervention, such as a bone marrow biopsy or central line placement. Patients may experience mild discomfort, bruising, or fatigue and should follow wound care instructions, rest adequately, and attend follow-up appointments to monitor recovery and results.

Immediate post-operative care

• During your hospital stay after the procedure, the doctor will monitor your vital signs like blood pressure, heart rate, and oxygen levels.
• The doctor will also prescribe pain medications to manage discomfort.
• Bandages are used to control and stop any bleeding.
• Rest is vital for successful healing. Avoid physically demanding activities.

Pain management and comfort

• Use painkillers like acetaminophen or ibuprofen to manage discomfort.
• Cold compresses can help reduce swelling.
• If the pain becomes severe and persistent, contact your doctor.
  

Monitoring for complications

• Mild bleeding and bruising at the procedure site are normal.
• Be aware of signs of infection. If you notice any, visit the hospital.
• Fatigue and dizziness are expected, especially if blood was drawn or marrow aspirated.

Long-term recovery

• Gradually return to normal activities over time.
• Follow-up appointments are very important. Stay organized and up to date, as your doctor will monitor your healing process.
• Healing time can range from a few weeks to several months, depending on the procedure.

Getting ready for your hematology test or treatment

Hematology procedures are crucial for diagnosing and treating blood-related conditions, but always remember that the healing journey doesn’t end once the procedure is over.

Proper preparation, a clear understanding of the steps during the procedure, and thoughtful post-operative care will ensure a smoother experience and faster recovery.