Hematology

Hematology

Hematology is the branch of science that deals with the prevention, diagnosis, treatment, and follow-up of diseases related to the blood, lymph nodes, spleen, and bone marrow. Hematology addresses congenital and acquired diseases causing low and high blood levels, blood clots, vascular occlusions, blood and bone marrow cancers, immune system diseases, and benign and malignant conditions affecting the lymph nodes and spleen.

Diagnostic methods include complete blood count, peripheral blood smear, biochemistry tests, bone marrow biopsy and aspiration, genetic tests, and imaging techniques.

Advancements in Hematology

Recent advancements in hematology have significantly improved the diagnosis and treatment of diseases. Individualized treatments based on genetic characteristics of the patient and disease offer higher success rates compared to traditional methods. These advanced approaches require a team of experts and state-of-the-art laboratories.

Main Hematological Diseases

• Anemia: Includes iron deficiency, vitamin B12 and folic acid deficiency, thalassemia, sickle cell anemia, and hemolytic anemia.
• Immune Disorders: Immune thrombocytopenia (ITP), Thrombotic thrombocytopenic purpura (TTP), Hemolytic uremic syndrome (HS).
• Bleeding Disorders: Hemophilia, Von Willebrand disease, Glanzmann thrombasthenia, Bernard Solier syndrome.
• Coagulation Disorders
• Bone Marrow Failure
• Leukemia: Acute (e.g., Acute Lymphocytic Leukemia, Acute Myeloid Leukemia) and Chronic Leukemia (e.g., Chronic Myeloid Leukemia, Chronic Lymphocytic Leukemia).
• Myelodysplastic Syndrome
• Myeloproliferative Diseases: Polycystic Vera, Essential Thrombocytosis, Myelofibrosis.
• Multiple Myeloma
• Lymphomas: Hodgkin and Non-Hodgkin lymphomas.

Lymphoma

Lymphoma is a cancer originating from the cells of the lymphatic system, which includes lymph nodes, spleen, bone marrow, and thymus gland. It is divided into Hodgkin and Non-Hodgkin lymphoma, with multiple subtypes in each category. Non-Hodgkin lymphoma is more common in older adults, while Hodgkin lymphoma typically occurs in two age groups: 15-40 and over 55.

Risk factors include immunosuppressive drug use, radiotherapy, immune system diseases, exposure to chemicals, and certain viral infections.

Symptoms: Swelling of lymph nodes (neck, armpit, groin), fatigue, fever, night sweats, weight loss, shortness of breath, early satiety, and skin itching.

Lymphoma can often be treated successfully with chemotherapy, immunotherapy, radiotherapy, or bone marrow transplantation, depending on the subtype and stage.

Polycythemia

Polycythemia is characterized by an increased level of red blood cells (erythrocytes). Diagnostic thresholds include:

• Hemoglobin > 16 g/dl or Hematocrit > 48% in women
• Hemoglobin > 16.5 g/dl or Hematocrit > 48.5% in men

Symptoms: Fatigue, dizziness, blurred vision, ringing in the ears, itching, excessive sweating, burning sensation in hands and feet, easy bruising, and bleeding.

Complications: Increased blood viscosity can lead to vascular occlusions, elevated blood pressure, and enlargement of the liver and spleen.

Enlargement of Lymph Nodes

Lymph nodes play a key role in the immune system and are distributed throughout the body. Sizes up to 1 cm are considered normal. Enlargement can indicate various conditions such as infections, rheumatic diseases, or cancers.

Key Indicators:

• Persistent enlargement for 2-3 weeks despite observation or antibiotics.
• Enlargement in multiple areas.
• Accompanying symptoms such as fever, weight loss, weakness, and night sweats.

Appropriate evaluations, including physical exams, laboratory tests, and imaging, should be performed. Consultation with a hematologist is recommended in such cases.

Chronic Myeloid Leukemia (CML)

CML is a slowly progressing blood cancer characterized by high numbers of immature white blood cells in the blood, bone marrow, and spleen. White blood cells are essential for immune function.

Symptoms: Fatigue, weakness, bone pain, abdominal fullness, fever, night sweats, and weight loss. In some cases, CML is diagnosed incidentally through routine blood tests.

CML symptoms typically progress over time, making early detection critical for effective treatment.