Hematology

The hematology is the branch of the Médecine which studies the Sang and its Maladie S (or Hémopathie S).

She studies more particularly the blood cells whose origin is hematopoietic (synthesis of these cells in osseous marrow) and who have a role for oxygenation, the immunity and the Coagulation, and studies also certain plasmatic molecules which are the factors of coagulation.

To have access under the terms frequently used in hematology to see vocabulary of hematology.

Distribution of the hematologic diseases in the population

Figures

The serious hematologic diseases, that are the lymphomas and leukemias, are not very frequent cancers, they have in France an incidence of respectively 15 new cases and 7 new cases per annum and for 100.000 people.

Risk factors

There are few risk factors listed for these diseases, one can quote:
  • the exposure to certain chemicals
  • the ionizing rays

For the defects of certain factors of coagulation and certain cells the risk factors are:

  • mode low in iron
  • mode low in certain vitamins
  • abundant rules

Preventive measures

The prevention simply consists in legislating and reducing the exposure to certain chemicals and ionizing rays, particularly in certain industries.

Fundamental disciplines in hematology

Anatomy and histology

Hematologic physiology

Physiology makes it possible to know which are the mechanisms concerning a medical field and to thus better include/understand the diseases and to better diagnose them and guerrir them.

  • the coagulation;

  • the Hématopoïèse;
  • genesis of cancers, to see Oncology;

List hematologic affections

The hematologic diseases are named Hémopathies.

Hematology is commonly divided into three pennies categories, according to the group of cells studied (red globules, leucocytes, Plaquettes). This subdivision remains incomplete, since many diseases affect some or all the components of the Sang and the osseous Moelle.

Most of the hémopathies is due either to the lack or with the excess of synthesis of these components of blood, for the blood cells it is about a problem at the time of a stage of the Hématopoïèse (synthesis of the blood cells in the bones) or in differentiations on the level of the secondary lymphoid bodies, and for the factors of coagulation of a problem to the liver.

It can also be a question of an excessive loss in periphery or synthesis of nonfunctional cells.

One thus finds in excess or certain cells in one or more of these compartments: osseous marrow, blood and the secondary lymphatic bodies.

One classifies the hémopathies as follows:

  • on the one hand benign hémopathies (for example by vitamin deficiencies, anomalies of the Hemoglobin or Hémoglobinopathie…) whose classification suggested takes again this plan mainly.
  • and in addition the malignant hémopathies:
    • Leukemia S: tumor of blood (the blood cells proliferate in blood)
    • Lymphome S: tumor in the secondary lymphoid bodies (such as for example the ganglia or spleen)
    • As with other diseases which have these syndromes:
    • Syndrome myelodysplasic: defect of synthesis of one or more of the types of following blood cells: red globules, white globules or plates
    • and myéloprolifératif Syndrome: excess of synthesis of one or more of the types of following blood cells: red globules, white globules or plates

One distinguishes four types of Leucémie S:

  • acute leukemia is characterized by the fast proliferation of immature cells of blood:
    • lymphoid acute Leukemia (LAL): The cells concerned come from the lymphoid line;
    • acute Leukemia myéloïde (LAM): The cells concerned come from the line myéloïde;
  • chronic leukemia, here the cancer cells are more mature, the evolution is done over months at years:

As for the Lymphoma S, they are divided into two groups:

The diseases causing a problem of coagulation are the coagulopathies, among those Ci there are the diseases whose origin is the érythrocyte, but also those whose origin comes from the factors of coagulation, they are the hemophilia.

One can also classify the hémopathies according to the origin of the touched cell:

The white globules

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The red globules or red blood corpuscles

  • Anémie
  • Hémoglobinopathie
  • Hello-immunization
  • Maladie of Be occupied
  • Drépanocytose
  • Thalassémie

The blood plates

The coagulopathies

  • disorders related on the bleeding and the coagulation
  • intravascular Hemophilia
  • disseminated Coagulation
  • Fibrinolyse thrombotic primitive
  • Thrombopathie
  • Microangiopathie
|}

Semiology

Principal clinical signs

Clinical signs:

Interrogation:

  • Old
  • Activity at the risk exposing to chemicals
  • Exposure to the pathogenic ones such as contact with a cat or stay in zone of parasitic endémie
  • Y' has you it have a risk of infection by the HIV
  • Signes of Anémie

General signs:

Complementary examinations

The tests most used in the study of the hematologic problems are:

  • the consistent Myélogramme in the coloring of smear (for example thanks to the Method of Romanowsky)

  • the Biopsy ostéomédullaire
  • explorations of coagulation, they are times of coagulation in fact:
    • Time of cephalin activated (TCA), (measurement the effect of cephalin injection, lipid close to the phosphatidyl serine)
    • Time of Quick (TQ) modified in Intertionalized normalized ratio (INR), (measurement the effect of tissue injection of factor)
    • Time of thrombin, (measurement the effect of thrombin injection)

Treatments

The treatments suggested are:
  • the use of Drug S in particular the iron supplementation or vitamin in the Anemia S

  • the blood Transfusion

    • Produced blood unstable (P.S.L.)
      • concentrated globular (in anemias and hemorrhages)
      • concentrated plate (in the thrombopénies)
      • fresh Plasma frozen (in the Coagulopathie S)
      • leucocytes
    • Drugs blood derivative
      • coagulating fractions (FVIII, FIX, PPSB in the intoxications with the vitamin K)
      • plasmatic albumin (in the nephrotic syndromes)

It should be noted that for the blood transfusions, it is necessary to resort to voluntary donors, either voluntary (in France in particular) or remunerated. This collection of blood is assured either by a public service (in France) or an ONG (Red Cross), or by private firms. The transfusional site which provides the products to the clinicians users is sometimes called " bank of the sang".

History of hematology

Famous Hematologists

  • Jean Bernard (1907 - 2006), hematologist French.

See too

  • Oncology

External bonds

  • Books on hematology

  • French company of hematology

Notes and references of the article

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