Abnormal Count

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Anemia refers to any of the body’s cells not being produced properly (red blood cells, white blood cells, or platelets). For example, in sickle cell anemia (a genetically inherited disease), the oxygen-carrying red blood cells are not produced properly and are misshapen.

Problems with the body’s bone marrow – where blood cells are manufactured – can alter the blood count, alerting a doctor to a more serious condition such as leukemia, lymphoma myeloma, or aplastic anemia.

Anemia occurs when your blood has a low hemoglobin level. (Hemoglobin is the red pigment in the blood which gives the blood its color.) Hemoglobin helps carry oxygen from the lungs to different parts of the body. It is made from iron. When your body doesn’t have enough iron, it can’t create new red blood cells, and this causes fatigue, lack of motivation, and other symptoms.

Anemia is not a disease in itself; rather, it is a symptom of an underlying problem. When you see a hematologist doctor about anemia, the doctor will investigate the possible causes of the anemia:

  • Abnormal thyroid function
  • Autoimmune diseases
  • Bleeding ulcers, polyps, and hemorrhoids
  • Bowel surgeries (including some bariatric surgeries)
  • Cancer of the blood cells
  • Chemotherapy for cancer and radiation therapy
  • Deficiencies of vital nutrients like iron and vitamin B-12
  • Disorders of the bone marrow
  • Genetic and inherited disorders like thalassemia and sickle cell disease
  • Inflammatory conditions like arthritis
  • Kidney failure
  • Some medications

As you can see, many conditions can cause anemia, which is why it should be evaluated thoroughly by an experienced hematologist.

The doctor will perform a type of blood test called a hemoglobin electrophoresis. To get a definitive diagnosis as to the cause of the anemia, the doctor may also need to examine the chromosomes and molecules from a sample of bone marrow.

Aplastic Anemia

Aplastic anemia (also called bone marrow aplasia) occurs when the body’s bone marrow stops producing blood cells. In this condition, the blood counts are very low and the patient may need transfusions of red cells platelets to survive.

This disease is rare, affecting 300 – 600 people per year in the United States. It is thought to be caused by exposure to toxic chemicals, radiation exposure to radiation, medications like chemotherapy, and even the patient’s own immune system (which destroys the marrow and its
capacity to form cells).

Aplastic anemia can be treated by replacing the damaged bone marrow with healthy marrow or stem cells from a donor. Another treatment option is with immunosuppressants – drugs that prevent the body from attacking its bone marrow.

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Condition in which the body produces defective blood cells. In response to this, the body uses its own immune system (referred to as the complement system) to destroy them. This can cause the body to develop acute leukemia, aplastic anemia, or blood clots in unusual places.

While treatment over 10 years ago consisted of a marrow or stem cell transplant, new monoclonal antibody drugs are shown to be very effective in treating this disease.

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