Hematology: Advanced

Anemia is one of the major reasons why patients present with shortness of breath, fatigue, pallor and weakness in clinics. Anemia is a reduction of the oxygen carrying capacity of the blood that results in decreased oxygen supply to tissue cells. It is of utmost importance for doctors to rule out anemia as a cause of this range of symptoms as not giving prompt medical treatment can result in severer symptoms and even fatality.

Hodgkin's disease is one of the first cancerous diseases for which effective treatment options have been developed. While this disease still ended lethally earlier, the prognosis is very good today. This is particularly due to the radiation sensitivity of lymphoma. 80 % of the patients can be cured permanently. This article provides a comprehensive overview of the hematologic disease, the symptoms, diagnosis and therapeutic principles.

Chronic myelogenous leukemia, also called chronic myeloid leukemia (CML), is an acquired monoclonal expansion of white blood cells of myeloid lineage. It is common in middle and old age accounting for 20% of adult leukemia. It is sometimes diagnosed incidentally on routine blood investigations or the presence of splenomegaly on examination. CML is classically associated with the Philadelphia chromosome (BCR-ABL fusion gene) and has excellent prognosis with modern therapy.

Acute lymphoblastic leukemia is a monoclonal malignancy of hematopoietic stem cells affecting the lymphoid lineage. It is the most common childhood cancer. The clinical manifestations are due to the replacement of normal marrow cells by the leukemic cells leading to bleeding, infections, and pallor. It has one of the best prognoses among cancers if treated timely.

Acute myeloid leukemia is due to a malignant transformation of the hematopoietic stem cells. It is predominantly seen in the age group of 50 – 60 years and is characterized by the arrest of leukocyte development in the early stage of development. Diagnosis is based on the presence of blast cells in the peripheral circulation. It is treated by chemotherapy, which includes treatment of remission and post-induction remission. Refractory cases of acute myeloid leukemia are treated by bone marrow transplants. Complications of AML include anemia, infections and bleeding, along with acute medical emergencies such as necrotizing enterocolitis, hyperleukocytosis and tumor lysis syndrome.

Chronic lymphocytic leukemia (CLL) affects the B-cells of the immune system and is, as the most common leukemia in adults, an important hematological differential diagnosis. It often hardly progresses for years and therefore a CLL does not always need immediate therapy. In the past years especially, a lot has happened with regard to diagnostic options and treatment, so that being informed about cytogenetic diagnostics and new treatment methods is extremely important.

In practice, anemia often appears in the blood count, accompanying many acute and chronic diseases. Clarification is definitely recommended because already a lowered hemoglobin value alone can be the first important hint for an undetected underlying disease. 

Many people suffer from cardiovascular diseases. Stroke and myocardial infarction rank among the most frequent causes of death due to cardiovascular diseases. The causes are blocked vessels and the resulting insufficient blood supply of vital organs and tissue. Surgeries are usually the last resort and, at the same time, the start of a new, safe and hopefully healthier life. In this article, you get to know more about the mechanism of action, the medical application as well as the possible side effects of anticoagulants.

Regardless if it’s playing sport, around the home or at work, cuts can happen everywhere in day to day life! There is a short spray of blood then a few minutes later the wound has closed itself with only a plaster reminding us of the little faux pas. But what happens if the apparently minor moment of carelessness suddenly becomes a life threatening event? What is ‘hemophilia’ as it’s commonly known? This article explains the range of blood disorders, which of them are hereditary and how an almost incident free life can still be led despite having one.

If not treated the aplastic anemia diseases leads to death. Everything you have to know as a future physician in this article. 

Burkitt lymphoma (small non-cleaved cell lymphoma) is one of the most aggressive and rapidly growing non-Hodgkin's lymphomas, with obvious predominance in children and young adults. This type of tumor requires urgent therapeutic intervention as the CNS and the bone marrow are involved in the malignant process since early stages of the disease.

Leukemia is blood cancer, this condition is characterized by exceeded amount of immature white blood cells in the blood stream (blasts), which normally remain in the bone marrow for their further maturity or sent to special organs (spleen, thymus) to get ready for their proper functioning. White blood cells are responsible for the adequate immune reaction of the body to various antigens (infections, malignant cells, foreign bodies, allergens); hence, immature cells cannot cover this function fully and fail to perform in the way m proper white cell do. Thus, the body easily contracts different infections as it is not capable to fight them, as the disease advances the bone morrow becomes exhausted shooting even more damaged cells or stops producing blood cells at all (hemogenic collapse).

There are two types of lymphomas - Hodgkin Lymphoma (Hodgkin`s Disease) and Non-Hodgkin Lymphoma. The follicular lymphoma belongs to the second group. It is a slow-growing B-cell lymphoma, and the second most common sub-type of NHL; most often occurs due to chromosomal translocation t(14;18) causing bcl-2 gene rearrangement. Most of the patients with FL are asymptomatic; hence they remain undiagnosed for years and usually detected in the advanced stages.

Non-Hodgkin's lymphomas (NHL) are hematological malignancies with high prevalence worldwide (accounts for about 4% of all cancer cases and 2.7% of all cancer deaths). They are cancers of the lymphatic tissues (mainly lymph nodes), affecting the lymphocytes, either B-cells (70%) or T-cells/NK cells (30%). NHLs are five times more common than the Hodgkin's lymphoma (HL). The following article discusses both B-cell type NHLs and T-cell type NHLs. 

Patients with myeloproliferative diseases can have chronic myelogenous leukemia, polycythemia vera, essential thrombocythemia or myelofibrosis. Disease transformation from one type into another is common. Different tyrosine kinase genes mutations have been identified and found to be related to myeloproliferative diseases which include bcr-abl, JAK2 and CALR mutations. Treatment of proliferative diseases is usually symptomatic, but disease specific treatments are also available.