When something is wrong with your blood, it can affect your total health.

That is
why it is important for you to know about some of the common blood disorders
that may affect you.
People may be affected by many different types of blood conditions and blood
cancers. Common blood disorders include anemia, bleeding disorders such
as hemophilia, blood clots, and blood cancers such as leukemia, lymphoma,
and myeloma.

What is Hematology?
Hematology is the study of blood in health and disease. It includes problems
with the red blood cells, white blood cells, platelets, blood vessels, bone marrow,
lymph nodes, spleen, and the proteins involved in bleeding and clotting
(hemostasis and thrombosis). A hematologist is a medical doctor who applies
this specialized knowledge to treat patients with blood conditions.

The Components of Blood and Their Importance

Many people have undergone blood tests or donated blood, but hematology the study of blood - encompasses much more than this. Doctors who specialize
in hematology (hematologists) are leading the many advances being made in
the treatment and prevention of blood diseases. If you or someone you care
about is diagnosed with a blood disorder, your primary care physician may refer
you to a hematologist for further testing and treatment.

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Plasma
The liquid component of blood is called plasma, a mixture of water, sugar, fat,
protein, and salts. The main job of the plasma is to transport blood cells
throughout your body along with nutrients, waste products, antibodies, clotting
proteins, chemical messengers such as hormones, and proteins that help
maintain the body's fluid balance.

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Red Blood Cells (also called erythrocytes or RBCs)

Known for their bright red color, red cells are the most abundant cell in the
blood, accounting for about 40-45 percent of its volume. The shape of a red
blood cell is a biconcave disk with a flattened center - in other words, both faces
of the disc have shallow bowl-like indentations (a red blood cell looks like a
donut).
Production of red blood cells is controlled by erythropoietin, a hormone produced
primarily by the kidneys. Red blood cells start as immature cells in the bone
marrow and after approximately seven days of maturation are released into the
bloodstream. Unlike many other cells, red blood cells have no nucleus and can
easily change shape, helping them fit through the various blood vessels in your
body. However, while the lack of a nucleus makes a red blood cell more flexible,
it also limits the life of the cell as it travels through the smallest blood vessels,
damaging the cell's membranes and depleting its energy supplies. The red blood
cell survives on average only 120 days.
Red cells contain a special protein called hemoglobin, which helps carry oxygen
from the lungs to the rest of the body and then returns carbon dioxide from the
body to the lungs so it can be exhaled. Blood appears red because of the large
number of red blood cells, which get their color from the hemoglobin. The
percentage of whole blood volume that is made up of red blood cells is called
the hematocrit and is a common measure of red blood cell levels.

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White Blood Cells (also called leukocytes)

White blood cells protect the body from infection. They are much fewer in
number than red blood cells, accounting for about 1 percent of your blood.
The most common type of white blood cell is the neutrophil, which is the
"immediate response" cell and accounts for 55 to 70 percent of the total white
blood cell count. Each neutrophil lives less than a day, so your bone marrow
must constantly make new neutrophils to maintain protection against infection.

Transfusion of neutrophils is generally not effective since they do not remain in

the body for very long.
The other major type of white blood cell is a lymphocyte. There are two main
populations of these cells. T lymphocytes help regulate the function of other
immune cells and directly attack various infected cells and tumors. B
lymphocytes make antibodies, which are proteins that specifically target
bacteria, viruses, and other foreign materials.

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Platelets (also called thrombocytes)

Unlike red and white blood cells, platelets are not actually cells but rather small
fragments of cells. Platelets help the blood clotting process (or coagulation) by
gathering at the site of an injury, sticking to the lining of the injured blood
vessel, and forming a platform on which blood coagulation can occur. This
results in the formation of a fibrin clot, which covers the wound and prevents
blood from leaking out. Fibrin also forms the initial scaffolding upon which new
tissue forms, thus promoting healing.
A higher than normal number of platelets can cause unnecessary clotting, which
can lead to strokes and heart attacks; however, thanks to advances made
in antiplatelet therapies, there are treatments available to help prevent these
potentially fatal events. Conversely, lower than normal counts can lead to
extensive bleeding.

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Complete Blood Count (CBC)

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A complete blood count (CBC) test gives your doctor important information
about the types and numbers of cells in your blood, especially the red blood
cells and their percentage (hematocrit) or protein content (hemoglobin), white
blood cells, and platelets. The results of a CBC may diagnose conditions
like anemia, infection, and other disorders. The platelet count and plasma
clotting tests (prothombin time, partial thromboplastin time, and thrombin time)
may be used to evaluate bleeding and clotting disorders.

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Your doctor may also perform a blood smear, which is a way of looking at your
blood cells under the microscope. In a normal blood smear, red blood cells will
appear as regular, round cells with a pale center. Variations in the size or shape
of these cells may suggest a blood disorder.

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Where Do Blood Cells Come From?

Blood cells develop from hematopoietic stem cells and are formed in the bone
marrow through the highly regulated process of hematopoiesis. Hematopoietic
stem cells are capable of transforming into red blood cells, white blood cells, and
platelets. These stem cells can be found circulating in the blood and bone
marrow in people of all ages, as well as in the umbilical cords of newborn babies.

Stem cells from all three sources may be used to treat a variety of diseases,
including leukemia, lymphoma, bone marrow failure, and various immune
disorders.
The Role of Red Blood Cells in Anemia

Red blood cells carry hemoglobin, an iron-rich protein that attaches to oxygen in
the lungs and carries it to tissues throughout the body. Anemia occurs when you
do not have enough red blood cells or when your red blood cells do not function
properly. It is diagnosed when ablood test shows a hemoglobin value of less than
13.5 gm/dl in a man or less than 12.0 gm/dl in a woman. Normal values for
children vary with age.
When you have anemia, your body lacks oxygen, so you may experience one or
more of the following symptoms:

Weakness

Shortness of breath

Dizziness

Fast or irregular heartbeat

Pounding or "whooshing" in your ears

Headache

Cold hands or feet

Pale or yellow skin

Chest pain

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Am I at Risk?

Many people are at risk for anemia because of poor diet, intestinal disorders,
chronic diseases, infections, and other conditions. Women who are menstruating
or pregnant and people with chronic medical conditions are most at risk for this
disease. The risk of anemia increases as people grow older. People who engage

in vigorous athletic activities, such as jogging or basketball, may develop

anemia as a result of red blood cells breaking down in the bloodstream.
If you have any of the following chronic conditions, you might be at greater risk
for developing anemia:

Rheumatoid arthritis or other autoimmune disease

Kidney disease

Cancer

Liver disease

Thyroid disease

Inflammatory bowel disease (Crohn disease or ulcerative colitis)

The signs and symptoms of anemia can easily be overlooked. In fact, many
people do not even realize that they have anemia until it is identified in a blood
test.

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Common Types of Anemia

Iron-deficiency anemia is the most common type of anemia. It happens when

you do not have enough iron in your body. Iron deficiency is usually due to blood
loss but may occasionally be due to poor absorption of iron. Pregnancy and
childbirth consume a great deal of iron and thus can result in pregnancy-related
anemia. People who have had gastric bypass surgery for weight loss or other
reasons may also be iron deficient due to poor absorption.
Vitamin-deficiency anemia may result from low levels of vitamin B12 or folate
(folic acid), usually due to poor dietary intake. Pernicious anemia is a condition
in which vitamin B12 cannot be absorbed in the gastrointestinal tract.
Anemia and Pregnancy - Learn about the risk factors and symptoms of
anemia during pregnancy.

Aplastic anemia is a rare form of anemia that occurs when the body stops
making enough red blood cells. Common causes include viral infections,
exposure to toxic chemicals, drugs, and autoimmune diseases. Idiopathic
aplastic anemia is the term used when the reason for low red blood cell
production is not known.
Hemolytic anemia occurs when red blood cells are broken up in the
bloodstream or in the spleen. Hemolytic anemia may be due to mechanical
causes (leaky heart valves or aneurysms), infections, autoimmune disorders, or
congenital abnormalities in the red blood cell. Inherited abnormalities may affect
the hemoglobin or the red blood cell structure or function. Examples of inherited
hemolytic anemias include some types of thalassemia and low levels of
enzymes such as glucose-6 phosphate dehydrogenase deficiency. The treatment
will depend on the cause.
Sickle cell anemia is an inherited hemolytic anemia in which the hemoglobin
protein is abnormal, causing the red blood cells to be rigid and clog the
circulation because they are unable to flow through small blood vessels.
Anemia caused by other diseases - Some diseases can affect the body's
ability to make red blood cells. For example, some patients with kidney disease
develop anemia because the kidneys are not making enough of the hormone
erythropoietin to signal the bone marrow to make new or more red blood cells.
Chemotherapy used to treat various cancers often impairs the body's ability to
make new red blood cells, and anemia often results from this treatment.

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How is Anemia Treated?

The treatment for anemia depends on what causes it.

Iron-deficiency anemia is almost always due to blood loss. If you have irondeficiency anemia, your doctor may order tests to determine if you are losing
blood from your stomach or bowels. Other nutritional anemias, such as folate or
B-12 deficiency, may result from poor diet or from an inability to absorb vitamins
in the gastrointestinal tract. Treatment varies from changing your diet to taking
dietary supplements.

If your anemia is due to a chronic disease, treatment of the underlying disease

will often improve the anemia. Under some circumstances, such as chronic
kidney disease, your doctor may prescribe medication such as erythropoietin
injections to stimulate your bone marrow to produce more red blood cells.
Aplastic anemia occurs if your bone marrow stops producing red blood cells.
Aplastic anemia may be due to primary bone marrow failure, myelodysplasia (a
condition in which the bone marrow produces abnormal red blood cells that do
not mature properly), or occasionally as a side effect of some medications. If you
appear to have a form of aplastic anemia, your doctor may refer you to a
hematologist for a bone marrow biopsy to determien the cause of the anemia.
Meedications and blood transfusions may be used to treat aplastic anemia.
Hemolytic anemia occurs when red blood cells are destroyed in the blood
stream. This may be due to mechanical factors (a leaky heart valve or
aneurysm), infection, or an autoimmune disease. The cause can often be
identified by special blood tests and by looking at the red blood cells under a
microscope. The treatment will depend upon the cause and may include referral
to a heart or vascular specialist, antibiotics, or drugs that suppress the immune
system.
Talk with your doctor if you believe you may be at risk for anemia. Your doctor
will determine your best course of treatment and, depending on your condition,
may refer you to a hematologist, a doctor who specializes in blood disorders.

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Is Anemia Preventable?

While many types of anemia cannot be prevented, eating healthy foods can help
you avoid both iron-and vitamin-deficiency anemia. Foods to include in your diet
include those with high levels of iron (beef, dark green leafy vegetables, dried
fruits, andnuts),vitamin B-12 (meat and dairy), and folic acid (citrus juices, dark
green leafy vegetables, legumes, and fortified cereals). A daily multivitamin will
also help prevent nutritional anemias; however, older adults should not take iron
supplementsfor iron-deficiencyanemia unless instructed by their physicians.

Bleeding Disorders
Bleeding disorders are a group of conditions that result when the blood cannot
clot properly. In normal clotting, platelets, a type of blood cell, stick together and
form a plug at the site of an injured blood vessel. Proteins in the blood called
clotting factors then interact to form a fibrin clot, essentially a gel plug, which
holds the platelets in place and allows healing to occur at the site of the injury
while preventing blood from escaping the blood vessel. While too much clotting
can lead to conditions such as heart attacks and strokes, the inability to form
clots can be very dangerous as well, as it can result in excessive bleeding.
Bleeding can result from either too few or abnormal platelets, abnormal or low
amounts of clotting proteins, or abnormal blood vessels.
Hemophilia is perhaps the most well-known inherited bleeding disorder,
although it is relatively rare. It affects mostly males. Many more people are
affected by von Willebrand disease, the most common inherited bleeding
disorder in America caused by clotting proteins. Von Willebrand disease can
affect both males and females. Platelet disorders are the most common cause of
bleeding disorder and are usually acquired rather than inherited. You can find
information on other bleeding disorders by following the links at the bottom of
this page.
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Am I at Risk?

Bleeding disorders such as hemophilia and von Willebrand disease result when
the blood lacks certain clotting factors. These diseases are almost always
inherited, although in rare cases they can develop later in life if the body forms
antibodies that fight against the blood's natural clotting factors. Individuals and
pregnant women with a family history of bleeding disorders should talk to their
doctors about detection and treatment. Symptoms of bleeding disorders may
include:

Easy bruising

Bleeding gums

Heavy bleeding from small cuts or dental work

Unexplained nosebleeds

Heavy menstrual bleeding

Bleeding into joints

Excessive bleeding following surgery

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What Is Hemophilia and How Is It Treated?

Hemophilia is a rare, typically inherited, bleeding disorder that can range from
mild to severe, depending on how much clotting factor is present in the blood.
Hemophilia is classified as Type A or Type B, based on which type of clotting
factor is lacking (factor VIII in Type A and factor IX in Type B). Hemophilia results
from a genetic defect found on the X chromosome. Women, who have two X
chromosomes, can pass the disease onto their sons but will be not be affected
by the disease unless both X chromosomes have the defective gene; this is very
rare. On the other hand, males, who have one X and one Y chromosome, will be
affected by hemophilia if their one X chromosome has the defective gene.
Because blood does not clot properly without enough clotting factor, any cut or
injury carries the risk of excessive bleeding. In addition, people with hemophilia
may suffer from internal bleeding that can damage joints, organs, and tissues
over time.
In the past, people with hemophilia were treated with transfusions of factor VIII
obtained from donor blood, but by the early 1980s these products were
discovered to be transmitting blood-borne viruses, including hepatitis and HIV.
Thanks to improved screening techniques, and a major breakthrough that
enabled scientists to create synthetic blood factors in the laboratory by cloning
the genes responsible for specific clotting factors, today's factor-replacement
therapies are pure and much safer than ever before.

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What Is von Willebrand Disease and How Is It Treated?

Von Willebrand disease is an inherited condition that results when the blood
lacks functioning von Willebrand factor, a protein that helps the blood to clot
and also carries another clotting protein, factor VIII. It is usually milder than
hemophilia and can affect both males and females. Women are especially
affected by von WIllebrand disease during menses. Von Willebrand disease is
classified into three different types (Types 1, 2, and 3), based on the levels of
von Willebrand factor and factor VIII activity in the blood. Type 1 is the mildest
and most common form; Type 3 is the most severe and least common form.
With early diagnosis, people with von Willebrand disease can lead normal, active
lives. People with mild cases may not require treatment, but should avoid taking
drugs that could aggravate bleeding, such as aspirin and ibuprofen, without first
consulting with a doctor. More serious cases may be treated with drugs that
increase the level of von Willebrand factor in the blood or with infusions of blood
factor concentrates. It is important for people with von Willebrand disease to
consult with their doctors before having surgery, having dental work, or giving
birth, so that proper precautions can be taken to prevent excessive bleeding.
You may be referred to a hematologist, a doctor who specializes in the treatment
of blood disorders.

Blood Cancers
Blood cancers affect the production and function of your blood cells. Most of
these cancers start in your bone marrow where blood is produced. Stem cells in
your bone marrow mature and develop into three types of blood cells: red blood
cells, white blood cells, or platelets. In most blood cancers, the normal blood cell
development process is interrupted by uncontrolled growth of an abnormal type
of blood cell. These abnormal blood cells, or cancerous cells, prevent your blood
from performing many of its functions, like fighting off infections or preventing
serious bleeding.

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Cancer Cells vs. Healthy Cells

There are three main types of blood cancers:

Leukemia, a type of cancer found in your blood and bone marrow, is caused by
the rapid production of abnormal white blood cells. The high number of
abnormal white blood cells are not able to fight infection, and they impair the
ability of the bone marrow to produce red blood cells and platelets.
Lymphoma is a type of blood cancer that affects the lymphatic system, which
removes excess fluids from your body and produces immune cells. Lymphocytes
are a type of white blood cell that fight infection. Abnormal lymphocytes become
lymphoma cells, which multiply and collect in your lymph nodes and other
tissues. Over time, these cancerous cells impair your immune system.
Myeloma is a cancer of the plasma cells. Plasma cells are white blood cells that
produce disease- and infection-fighting antibodies in your body. Myeloma cells
prevent the normal production of antibodies, leaving your body's immune
system weakened and susceptible to infection.