Classical hematology is the treatment of diseases of the blood. Blood cancers are generally not treated by classical hematology, with the exception of some of the myeloproliferative neoplasms, such as polycythemia vera and essential thrombocytosis. At WVU Medicine, our team comes together from different specialties — including hematology, pharmacy, pathology, transfusion, and radiology — to develop and deliver targeted therapies designed just for you.
Some blood conditions can be inherited and diagnosed in childhood or adulthood. Some benign blood conditions develop over time or as a result of another disease or related treatment. If you are diagnosed with classical hematology, it means you have a problem with either your body’s red blood cells, white blood cells, platelets, or proteins that impact bleeding and clotting.
Types of Classical Hematology Blood Disorders We Treat
There are many different types of noncancerous blood conditions. At the WVU Cancer Institute, we treat a broad range of cancerous and noncancerous blood disorders. Conditions we treat include:
Bleeding disorders
Some bleeding disorders are inherited, others develop over time. Inherited bleeding disorders include hemophilia, von Willebrand disease, other factor deficiencies, and disorders of platelet function. These conditions can cause recurrent and severe nosebleeds, bleeding from the gums, excessive bleeding from minor injuries, spontaneous bleeding into joints, and unexpected bleeding from surgery or childbirth.
Some bleeding disorders are acquired. These include cirrhosis, sepsis with disseminated intravascular coagulation, acquired hemophilia A, acquired von Willebrand disease, and medication effects. Many herbal supplements, over-the-counter medications, and prescription medications can cause bleeding. The WVU Hemophilia Treatment Center specializes in care of patients with known hemophilia and related bleeding disorders.
Platelet disorders
Platelet disorders can be inherited, and some are acquired over time. Some disorders affect how well the platelets work, and some disorders affect the number of platelets available to function. Low platelets can make bleeding more likely to happen, and patients with decreased platelet function can have bleeding with surgery even if the platelet number is normal. Low platelets can be a sign of an underlying problem, such as cirrhosis, or it may be a sign of a blood condition from the immune system recycling platelets too fast (immune thrombocytopenia).
High platelets may be the sign of an underlying blood condition that needs treatment, but most commonly, it is from obesity or an underlying inflammatory disorder.
Special types of platelet disorders, such as atypical hemolytic uremic syndrome or thrombotic thrombocytopenic purpura, require specialized care to prevent severe problems from kidney damage, strokes, heart attacks, and bleeding. WVU Medicine has developed a special thrombotic microangiopathy team with experts in hematology, transfusion medicine, nephrology, and obstetrics to improve patient outcomes.
Red cell disorders
Red cell disorders affect the cells in your blood that carry oxygen from your lungs to the rest of your body. Disorders can be of high red blood cells or low red blood cells. High red blood cells are most often found with sleep apnea, smoking, testosterone use, and very rarely, conditions that run in families, such as polycythemia vera. Low red blood cells are more common. This can be from sickle cell anemia, thalassemia, iron deficiency anemia, red cell structural problems, and anemia due to chronic disease. Hemolytic anemia is another red cell disorder where the cells are recycled faster than normal.
White cell disorders
White cell disorders affect the white blood cells (leukocytes) and your body’s ability to fight infection. There are many different types of leukocytes, each have special functions; and abnormalities of each type can have several different underlying causes.
Myeloproliferative disorders
These conditions cause high red blood cells (hemoglobin), high platelets, and can cause high white blood cells. Polycythemia vera is one cause of a high hemoglobin, and essential thrombocytosis is a family of conditions that cause high platelets. These conditions are technically blood cancers, but they are treated in classical hematology because the types of treatments used are very different than other types of cancer (such as breast cancer or leukemia). This diverse family of blood cancers often does not require treatment, and when treatments are needed, it may not include chemotherapy.
Venous blood clots
The blood clotting system functions to prevent bleeding. This delicate balance between bleeding and clotting means that many people will develop blood clots that need treatment. Venous blood clots are commonly triggered by surgery, increasing age, obesity, major injuries, pregnancy, medications, cancers, or cancer therapy. Rarely, blood conditions can make clots occur, and these need special treatment, such as thrombotic antiphospholipid antibody syndrome. Often, people will have blood clots with no clear provoking cause (minimally provoked or unprovoked). Blood clot treatment requires specialized care because the anticoagulants that are used to treat these blood clots all have the risk of increasing bleeding, and this can be severe. The type of medicine, the dose, and the duration of therapy are conditions where a benign hematologist can help reduce the risk of repeat blood clots and also reduce the risk of bleeding.
Although strokes, heart attacks, and limb ischemia are also caused by blood, these conditions occur from non-hematology conditions in the vast majority of cases. In these conditions, the blood is reacting as it is supposed to, but it is reacting to a damaged blood vessel. Risks for these types of problems include smoking, high blood pressure, high cholesterol, physical inactivity, and cardiac conditions, such as atrial fibrillation. These conditions are usually treated by neurology (stroke), cardiology (heart attack), or vascular surgery (limb ischemia).
Diagnosing Classical Blood Disorders
Our doctors will talk with you about your symptoms, complete a full health history, and examine you for signs of a blood-related problem. We diagnose blood disorders using:
- Blood tests — Doctors use a number of tests for blood disorders. Some of these tests are very simplistic and provide answers in a number of hours, and some are very specialized and only offered at a few centers in the country and provide answers in six to eight weeks.
- Bone marrow tests — Doctors remove blood cells from your marrow with a thin needle to look for abnormalities in your chromosomes or genes.
- Imaging tests — Doctors use ultrasound, CT, MRI, and PET scans.
Treatment for Classical Blood Disorders
From your first visit, our team works with you to address your specific condition and needs.
Your care plan may include:
- Anticoagulation management
- Blood/platelet transfusion
- Healthy lifestyle guidance
- Infusion therapies
- Oral medicines
- Treatments needed to enable safe surgery
We will also provide a written documentation of our discussion in the form of an after-visit summary to help you understand and remember the details of your evaluation and to empower you to discuss your care with your loved ones if you choose to.
Resources
We believe care goes beyond the medical diagnosis and treatment. That’s why each person can access many resources that may help answer questions and connect you to others.