Diseases

Hematology – Treatment, Effect & Risks

Hematology

Hematology is the study of blood and its functions. The branch of medicine relates to the physiology and pathology of the blood. Hematology is of great importance in routine diagnostics, in the follow-up of a wide variety of diseases, but also in basic research. More than 90 percent of all medical diagnoses are based on haematological findings .

What is hematology?

Hematology is a word of Greek origin combined from the two syllables Haima, the blood, and Logos, the doctrine. Thus, literally translated, hematology means the study of blood. In clinical application, the pathology of the blood is particularly important. The composition of the blood is altered in a characteristic way in a wide variety of diseases, so that haematological values ​​allow a direct conclusion to be drawn about defective bodily functions.

Basically, the science of hematology consists of what is known as numerical hematology and cellular hematology. Numerical hematology is primarily concerned with the normal values ​​and the circulating blood cells that deviate from these normal values.

Cell hematology as a sub-area includes the analysis of cell structures of blood cells or cells of the bone marrow . The most important cell hematological method is the so-called differential blood count of the white blood cells, leukocytes . Another sub-area of ​​hematology is hemato-oncology, which deals specifically with malignant neoplasms in the blood or bone marrow.

The best-known hematological, malignant disease is leukemia , about 500 different forms of leukemia are known to date. While some of these have an extremely good prognosis and chance of recovery for the patient, other forms, such as acute lymphatic leukemia, usually lead to death within a few weeks of diagnosis.

Treatments & Therapies

The simplest hematological examination is the creation of a small blood count, consisting of the number of leukocytes, erythrocytes , thrombocytes and hemoglobin . It is a general examination in the family doctor ‘s practice or as an initial examination when admitted to a hospital. Normal values ​​can already rule out many diseases. However, if the values ​​of the blood count have changed significantly, these pathological findings must always be further clarified by means of differential diagnostics. 

The most important hematological normal values ​​are leukocytes 4000-9000, erythrocytes 4.5-5.5 million, thrombocytes 180,000-300,000, hematocrit 38-41% and hemoglobin 12-17g. All information relates to 1 cubic millimeter of whole blood. Hemoglobin is the blood pigment contained in the red blood cells, erythrocytes. During gas exchange in the lungs, hemoglobin has the ability to bind oxygen to itself and thus supply all body cells with vital oxygen through the bloodstream . If there is a lack of hemoglobin due to an illness or an accident, the hemoglobin value can be increased again by administering blood products, so-called erythrocyte concentrates.

However, this is mostly unsuccessful if the cause of the drop in hemoglobin is internal bleeding , for example in the gastrointestinal tract . The hematocrit value reflects the volume fraction of all cellular components in the whole blood. With the exception of the differential blood count, all numerical-hematological parameters are now determined with fully automatic devices in medical laboratories. However, the differential blood count requires a manual, microscopic examination of the stained blood smear.

The main issue here is the splitting of the white blood cells into the individual leukocyte fractions. Important leukocyte fractions are neutrophilic granulocytes , basophilic granulocytes, eosinophilic granulocytes and small and large lymphocytes. They all occur physiologically in the flowing blood. Bone marrow cells, such as plasma cells, myelocytes, metamyelocytes, or promyelocytes, are not normally found in the blood. If these can be seen in the differential blood count, one also speaks of a left shift, which is always to be regarded as pathological.

The most common causes of a shift to the left are inflammatory changes and infections. This type of left shift is reactive, i.e. reversible and disappears with therapy. In the case of leukemia, on the other hand, the left shift is irreversible, so the pathological bone marrow cells appear permanently in the bloodstream.

Diagnosis & examination methods

All hematological examination methods are part of laboratory medicine. The blood is examined hematologically in the medical laboratory by specially trained specialists, the medical-technical laboratory assistants, MTLA. To do this, the blood taken from a vein must be made non-coagulable. An anticoagulant, EDTA, is therefore included in the blood tubes for haematological examinations. The technical and medical validation and release of the haematological findings is always the responsibility of a specialist in laboratory medicine.

Special semi-automatic or fully automatic machines are used for cell hematology, which can hematologically analyze a large number of blood samples under the supervision of the laboratory staff within a very short time. The hematological diagnosis appears simple at first, but is then quite complex when it comes to assigning pathological findings to a patient’s complaints. In the case of a large number of hematological diseases, interdisciplinary cooperation between laboratory medicine, pathology, cytology and radiology is therefore required.

In the therapy of haemato-oncological diseases, the hematology values ​​are primarily used to monitor the progress, because the parameters allow important conclusions to be drawn about the course and prognosis of haematological diseases. Hematological diseases are very multifaceted and complex. The most important hematological symptoms include leukemia, lymphoma, the various types of anemia , hemoglobin formation disorders and what are known as storage diseases such as hemochromatosis .

The prognosis of hematological diseases also depends in particular on genetic factors. In detail, these gene factors cannot be influenced to this day. Hematology has made significant progress in recent years, but the research spectrum is far from exhausted. The changes in this area of ​​laboratory medicine therefore have the potential to fundamentally change medicine for patients in the future through basic research.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.