Blood disorders fall into three broad categories: acquired blood disorders, inherited blood disorders (also called congenital blood disorders), and blood disorders that develop as a consequence of cancer or treatment for cancer.
Overview and Symptoms
Types of Benign Blood Disorders
Benign blood disorders include:
- Anemia, including iron deficiency anemia, vitamin B12 deficiency, immunohemolytic anemias, and hemoglobinopathies (abnormal hemoglobins in the blood)
- Polycythemia (too many red blood cells)
- Leukocytopenia (too few white blood cells)
- Leukocytosis (too many white blood cells)
- Lymphocytosis (too many lymphocytes in the bloodstream)
- Neutropenia (too few neutrophils, a type of white blood cell)
- Thrombocytopenia (too few platelets in the blood)
- Thrombocythemia (too many platelets in the blood)
- Monoclonal gammopathies (an overproduction of immune globulin in the blood)
- Hypogammaglobulinemia (too few immunoglobulins in the blood)
- Coagulation disorders (both bleeding and clotting)
Blood disorders can range from life-threatening to very mild, meaning they don’t affect day-to-day life and just happen to be detected during a routine blood test.
Acquired Blood Disorders
Acquired benign blood diseases range from different types of anemia due to chronic blood loss; to inability to absorb vitamin B12 leading to a nutritional deficiency; to monoclonal gammopathy, a disorder that causes an overproduction of a single type of protein, immune globulin, in the blood.
Most benign blood diseases respond well to treatment with few, if any symptoms, and do not impact your longevity. In some cases, though, benign disorders can progress to more serious underlying conditions. For example, in some instances monoclonal gammopathy can develop into plasma cell myeloma or multiple myeloma (cancers of the bone marrow), or possibly lymphoma (cancer of the lymphatic system).
Inherited Blood Disorders
Although passed on at birth, congenital (inherited) blood disorders may not cause symptoms until later in life. Inherited blood disorders can lead to chronic or potentially life-threatening illnesses, and include:
- Sickle cell anemia, an inherited red blood cell disorder in which the red blood cells have a sickle shape (instead of the typical round shape). This can cause leg ulcers, jaundice and joint pain.
- Hemophilia and thrombophilia, hereditary blood-clotting disorders. With hemophilia, the blood does not clot normally; with thrombophilia there is too much clotting.
Blood Disorders Related to Cancer
Blood disorders such as anemia, blood clotting problems or bone marrow failures can arise as a side effect of cancer or treatment for cancer.
Chemotherapy sometimes causes blood-clotting problems because it interferes with the bone marrow's ability to produce platelets (blood cells that cause clotting to help stop bleeding). If your platelet count falls too low during chemotherapy, you may need a platelet transfusion or medicine to stimulate your own platelet production.
Because chemotherapy can damage bone marrow, it may cause myelodysplastic syndrome (MDS), a type of blood disease in which the bone marrow does not produce enough blood cells; or acute myelogenous leukemia (AML), a type of blood cancer characterized by excessive numbers of white blood cells. In some cases MDS (a benign blood disorder) progresses until it becomes AML (a cancerous blood condition).
Blood Disorder Diagnosis
In addition to reviewing your medical history, your hematologist will request a physical examination, blood testing, and laboratory analysis to diagnose your particular blood disorder.
Hematologists and hematopathologists (pathologists who specialize in blood conditions) examine a sample of your blood under a microscope to analyze red cell, white cell and platelet morphology (shape). Sometimes additional tests, such as a bone marrow biopsy, may be necessary.
Our physicians are especially skilled at discerning benign blood diseases from underlying cancer-related hematologic conditions, and then tailoring care accordingly.
Interventions for benign hematologic disorders may involve:
- Watchful waiting to monitor symptom progression
- Oral or intravenous medications
- Injections, including vitamin B12 or coagulation factors
- Blood transfusions: red cell, plasma or platelet
- Therapeutic phlebotomy to remove units of blood at specific intervals
- Apheresis, a mechanical apparatus similar to dialysis that filters, separates and returns blood to the patient, but after removing white blood cells, platelets or plasma depending upon the diagnosis.
- Photopheresis, similar to apheresis, is another procedure physicians use to treat certain patients with a leukemia-like phase of cutaneous T-cell lymphoma. Photopheresis removes and treats the blood with drugs that are activated by ultraviolet light to target the white blood cells. The blood is then returned to the patient.
Severe Blood Disorders
Severe cases of benign hematologic disorders, such as bone marrow failure or sickle cell anemia, may be treated with bone marrow or stem cell transplantation, or with surgery to remove the spleen.