Oregon Hematology Oncology Associates

What is hematology?

Hematology is the study of blood, and hematologists specialize in the diagnosis and treatment of all aspects of blood-related conditions. These include problems related to blood counts, abnormal iron levels, coagulation problems (either inadequate blood clotting or excessive blood clotting), and a rare condition known as porphyria. Seeing a hematologist does not necessarily mean that you have cancer, although hematologists are also trained in the diagnosis and management of cancers of the blood system. For what kind of conditions might you be referred to a hematologist?

Abnormal blood counts

There are three basic types of blood cells: red blood cells, white blood cells, and platelets. For each type of cell, there are diseases associated with having too little or too many of these cell types.

For example, one may have a low red blood cell count (anemia) or have an abnormally high red blood cell count (polycythemia), a low white blood cell count (leukopenia) or an abnormally high white blood cell count (leukocytosis), and finally a low platelet count (thrombocytopenia) or an abnormally high platelet count (thrombocytosis or thrombocythemia). Each of these abnormalities may be caused by a variety of conditions, and your hematologist must consider many factors which may be relevant.

Abnormal iron levels

Iron deficiency is a common condition and it is usually not difficult to identify the cause. Sometimes, however, the usual signs of iron deficiency may not be apparent, or sometimes the deficiency does not respond readily to iron supplements. Your primary care physician may feel that there is something interfering with your absorption of iron or your iron metabolism, and has referred you to facilitate your recovery. Iron can also be present in excess, and diseases in this category, such as hemochromatosis, require timely diagnosis and treatment.

Coagulation disorders

The coagulation system is essential in preventing one from bleeding excessively after injury. However, sometimes there is a deficiency in the ability to clot, resulting in easy bleeding and bruising. This may be potentially life-threatening or relatively minor, however, it may prevent or delay necessary surgery or dental work or complicate pregnancy. Furthermore, some of the disorders in this category are hereditary and making a diagnosis may be important for your relatives.

Sometimes the coagulation system works too well, causing blood clots to develop spontaneously. These conditions may also be hereditary, but may also be related to other medical conditions as well. Identifying precisely why your blood is forming clots abnormally will determine the appropriate anticoagulation therapy.

Porphyria

Hemoglobin is the protein in red blood cells that physically carries oxygen molecules to your vital organs. Hemoglobin doesn’t bind the oxygen molecule directly, however. Instead, the oxygen is held in a ring-like molecular clamp called heme. Sometimes (rarely) there is a defect in one of the genes that is involved in the assembly-line synthesis of the heme molecule. When the assembly-line malfunctions, molecules of the partially-assembled heme build up behind the problem step, and accumulate in the body. These often toxic by-products cause a variety of symptoms and signs that can often be difficult to diagnose. This group of disorders is hereditary and also can have impact on other family members.

Blood malignancies

As with other cells in the body, blood cells can become cancerous. When they do so, these malignant cells circulate wherever blood circulates. Therefore the approach to blood malignancies is very different from that of other kinds of cancers. And since blood is manufactured in the bone marrow, an examination of the bone marrow is often a part of the initial evaluation. Diseases in this category include leukemia , myeloma, and lymphoma.

As you can see, there are many conditions for which you may be referred to see a hematologist. We realize that many of these conditions are ones with which most people are unfamiliar. We are happy to provide resources to help you understand your condition and its treatment.

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©2003 Oregon Hematology Oncology Associates, P.C., Inc. All rights reserved. This site is for educational purposes only and is intended for your general knowledge. It should not be used as a substitute for advice from your physician or other healthcare professional.