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Other Hematological Disorders

The Hemato-Oncology Division of the IEO treats several other hematological disorders, managed by the team of specialist doctors and nurses with a multidisciplinary approach. The hematologica disorders treated at IEO are: Chronic Myeloproliferative Neoplasms, Chronic Myeloproliferative Neoplasms, Primary Myelofibrosis, Essential thrombocythemia, Chronic neutrophilic leukemia and Chronic eosinophilic leukemia.

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IN SHORT

Besides the most frequent blood cancers, this is a short list, with some additional information of the most representative blood cancers classified as other hematological disorders.

Chronic Myeloproliferative Neoplasms: this is a group of blood cancers, characterized by the overproduction of blood cells by BM. The BM can make too many red blood cells, white blood cells, or platelets. Thus, chronic myeloproliferative neoplasms includes six different diseases, each characterized by abnormalities of specific hematopoietic cell lineage, that are here listed: 

 

  • Chronic Myelogenous Leukemia (CML), that has been described above, under the Chronic Leukemia section
  • Polycythemia Vera (PV), characterized by overproduction or red blood cells
  • Primary Myelofibrosis (also called chronic idiopathic myelofibrosis), characterized by marrow fibrosis and expansion of the spleen, leading to abnormal splenomegaly
  • Essential thrombocythemia (ET), characterized by overproduction of platelets
  • Chronic neutrophilic leukemia, with overproduction of neutrophilic granulocyte, in the absence of the specific cytogenetic marker of CML
  • Chronic eosinophilic leukemia, with overproduction of eosinophilic granulocyte

STAFF

At the IEO other hematological disorders are treated by a multidisciplinary team consisting of specialists in:

RISKS FACTORS FOR OTHER HEMATOLOGICAL DISORDERS

Other hematological disorders risk factors are:

  • Age
  • Family history
  • Obesity
  • Having other plasma cell disorders
  • Exposure to cancer-causing agents
  • Having other plasma cell disorders
  • Previous chemotherapy or radiation therapy

PREVENTION AND DIAGNOSIS

Blood tests with analysis of CBC (number of red blood cells, platelets, number and types of white blood cells), and morphological evaluation of PB smears, with particular attention to the shape of red blood cells and the presence of immature myeloid cells

BM aspirate and BM biopsy, with morphological examination of BM smear along with BM histological examination

Additional biologic investigations on BM cells are now mandatory, including cytogenetic analysis to look for certain changes in the chromosomes and molecular studies, with particular attention to identify possible mutations of the JAK-2 gene

Leukopenia (decrease in the number of white blood cells) - Anemia (decrease of hemoglobin and red blood cells) - Thrombocytopenia (decrease in the number of platelets): these are abnormalities that can be observed at routine laboratory controls and may be ascribed to a variety of underlying diseases. In some instances, these abnormalities of CBC can be due to an impaired BM function and appropriate diagnostic investigations should be planned, following hematologic consultation   

In distinct conditions, BM cellularity is markedly reduced, in other words BM is hypoplastic, with a variably low residual hematopoiesis. In the absence of any known reasons of marrow hypoplasia, the diagnosis can be of Aplastic anemia. BM function impairment causes a variable reduction of CBC, i.e. the so called “pan-cytopenia”. When CBC values are profoundly depressed, the diagnosis is of Severe Aplastic Anemia (SAA). Careful BM examination is mandatory whenever a condition of Aplastic Anemia is suspected. Once the diagnosis is confirmed, appropriate treatments should be promptly instituted. At present, there are two main treatment options for SAA. Since SAA is often an immunological-driven disease, intensive immunosuppression can be delivered, along with BM stimulation by hematopoietic cytokines. The alternative approach is to replace the impaired BM with normal hematopoietic stem cells donated by a volunteer donor, that is the alloSCT procedure.

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PARTNERSHIP

Università degli Studi di Milano

MAIN CREDITS

Ministero della Salute Joint Commission International bollinirosa

© 2013 Istituto Europeo di Oncologia - via Ripamonti 435 Milano - P.I. 08691440153 - Codice intermediario fatturazione elettronica: A4707H7

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