Hematology (BE: haematology) is the branch of internal medicine and pediatrics that is concerned with blood, the blood-forming organs and blood diseases. Hematology includes the study of etiology, diagnosis, treatment, prognosis, and prevention of blood diseases.

Blood diseases affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, the mechanism of coagulation, etc.

Hematologists

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Medical doctors who work in hematology are known as hematologists. Their routine work may range from the management of the hematology laboratory, work at the microscope viewing blood films and bone marrow slides, interpretation of various hematology test results, care of in-patients and care of out-patients.

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Join this expanding Department of Medicine and a group of academic and highly dedicated physicians during an exciting time of growth. There are opportunities to play a key role in developing the Hematology
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Enjoy the best of both worlds! In this position you will have the satisfaction of fostering the growth of tomorrows physicians, as well as working in a thriving practice. Be a part of a team that
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Hematological Oncology

Silibinin can induce differentiation as well as enhance vitamin D3-induced differentiation of human AML cells ex vivo and regulates the levels of differentiation-related transcription factors
Jing Zhang, Jonathan S Harrison, Milan Uskokovic, Michael Danilenko, George P Studzinski Wed, 28 Oct 2009 04:28:00 -0000
Induction of terminal differentiation is a conceptually attractive approach for the therapy of neoplastic diseases. Although vitamin D derivatives (deltanoids) can induce differentiation of AML cells in vitro, so far deltanoids have not been successfully brought to the clinic, due to the likelihood of life-threatening hypercalcemia. Here, we incubated freshly obtained blood cells from patients with AML with a plant antioxidant (PAOx), silibinin (SIL), alone or together with a deltanoid. Twenty patients with AML (all subtypes except M3) were available for this study, and in 14 (70%), SIL (60 µM) either induced differentiation ex vivo, or enhanced differentiation induced by deltanoids, or both. Interestingly, SIL acting alone induced differentiation only in cases in which chromosome aberrations could not be detected. In eleven samples sufficient material was available for a limited analysis of the underlying events. Quantitative RT-PCR showed that differentiation markers were upregulated at the mRNA level by both SIL and deltanoids, suggesting that intracellular signaling pathways upstream of transcription factors (TFs) were activated by these agents. Western analysis for proteins which function as TFs in deltanoid-induced monocytic differentiation, such as members of Jun and C/EBP families, surprisingly demonstrated that SIL upregulated all these TFs in the cases tested. This suggests that although the presence of SIL may not always be sufficient to induce differentiation, it can serve as a differentiation enabling factor for blasts obtained from a large proportion of patients with AML. Thus, SIL/deltanoid combinations warrant further consideration as preventive/therapeutic regimens in human leukaemia. Copyright © 2009 John Wiley & Sons, Ltd.
Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach
Cristiana Bellan, Lazzi Stefano, De Falco Giulia, Emily A Rogena, Leoncini Lorenzo Tue, 20 Oct 2009 22:14:00 -0000
Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an 'aggressive B-cell non-Hodgkin's lymphoma', characterized by a high degree of proliferation of the malignant cells and deregulation of the c-MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of 'B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma', now listed in the updated WHO classification. Copyright © 2009 John Wiley & Sons, Ltd.
Outcomes for lymphoid malignancies in the Nurses' Health Study (NHS) as compared to the Surveillance, Epidemiology and End Results (SEER) Program
Gregory A Abel, Kimberly A Bertrand, Craig C Earle, Francine Laden Wed, 28 Oct 2009 04:30:00 -0000
Vital statistics for the lymphoid malignancies obtained from the Surveillance, Epidemiology and End Results (SEER) Program have seldom been directly compared to data from alternative national databases. While SEER is recognized as the standard, some lymphoid malignancies - especially the chronic ones - may be underreported. We compared the incidence, all-cause and cause-specific mortality for Hodgkin's lymphoma (HL), non-Hodgkin's lymphoma (NHL), multiple myeloma (MM) and chronic lymphocytic leukaemia (CLL) in SEER to that in the Nurses' Health Study (NHS), a national cohort study of 121 700 female registered nurses, matching for age and race. In over 2.5 million person-years, the incidence of HL was the same as in SEER (SIR = 1.01 [0.75, 1.26]), while the incidence of NHL, CLL and MM were slightly higher. All-cause mortality was lower for the lymphoid malignancies except for MM, which was the same; there were no differences in cause-specific mortality, except for MM (HR = 1.26 [1.07, 1.48]). Our analysis suggests that, at least among white women, SEER is a reliable data source with respect to lymphoid malignancies. Copyright © 2009 John Wiley & Sons, Ltd.

Annals of Hematology

Impact of critical care reconfiguration and track-and-trigger outreach team intervention on outcomes of haematology patients requiring intensive care admission
Thu, 29 Oct 2009 19:38:16 -0000
Abstract  Patients with haematological disorders have previously been considered to have poor outcomes following admission to intensive care units. Although a number of haematology centres from outside the UK have now demonstrated improved outcomes, the continuing perception of poor outcomes in this patient group continues to adversely affect their chances of being admitted to some intensive care units (ICUs). Over the past 10 years, there have been many advances within the disciplines of both haematology and intensive care medicine. This study was done to assess outcomes and the impact of an early warning scoring system (EWS) and early involvement of ICU outreach teams. One hundred five haematology patients (haematopoietic stem cell transplant (HSCT) or non-HSCT) had 114 admissions to ICU between April 2006 and August 2008 which coincided with hospital-wide implementation of EWS. The survival to ICU discharge was 56 (53%). Thirty-three (33%) patients were alive at 6 months giving a 1-year survival of 31%. Of the 39 HSCT patients, nine were post-autologous and 30 post-allogeneic transplant. The survival to ICU discharge was 22 (56%) with 14 (36%) patients alive at 6 months. One year survival was 36%. Prior to the introduction of EWS and critical care outreach team (2004), survival to ICU discharge was 44% which has increased to 53% (2006–2008). This is despite an increase in mechanical ventilation in 2006–2008 (50%) as compared to 2004 (32%).The improvement in ICU survivorship was even more prominent in HSCT patients (37% in 2004 versus 56% in 2006–2008). There was a trend towards decreasing Acute Physiology and Chronic Health Evaluation scores with time, suggesting appropriate patients being identified earlier and having timely escalation of their treatment. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00277-009-0853-0Authors Syed W. I. Bokhari, Nottingham University Hospitals—City Campus Department of Clinical Haematology Nottingham UKTalha Munir, Nottingham University Hospitals—City Campus Department of Clinical Haematology Nottingham UKShabeeha Memon, Nottingham University Hospitals—City Campus Department of Clinical Haematology Nottingham UKJenny L. Byrne, Nottingham University Hospitals—City Campus Department of Clinical Haematology Nottingham UKNigel H. Russell, Nottingham University Hospitals—City Campus Department of Clinical Haematology Nottingham UKMartin Beed, Nottingham University Hospitals—City Campus Critical Care Department Nottingham UK Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555
Patients with del(5q) MDS who fail to achieve sustained erythroid or cytogenetic remission after treatment with lenalidomide have an increased risk for clonal evolution and AML progression
Fri, 23 Oct 2009 18:52:52 -0000
Abstract  Lenalidomide consistently induces transfusion independence and complete cytogenetic response in patients with myelodysplastic syndromes with 5q deletion. Only limited information on long-term outcome is currently available. We performed a long-term follow-up analysis of 42 patients with low or intermediate risk myelodysplastic syndromes and 5q deletion treated with lenalidomide. At a median follow-up of 40 months, 58% of the patients achieved an erythroid response and 48% a cytogenetic response. Thirty-six percent of patients progressed into acute myeloid leukaemia. Most of them (87%) acquired chromosome aberrations in addition to the 5q deletion, i.e. underwent clonal evolution during leukaemogenesis. There were no clinical, cytological or cytogenetic markers at study entry that allowed prediction of increased risk of leukaemic transformation. However, erythroid and cytogenetic responders had a significantly decreased risk of progression to acute myeloid leukaemia (p = 0.001 and p = 0.009, respectively) compared to non-responders. Three and 5 years after study entry, the cumulative incidence of acute myeloid leukaemia for patients with a cytogenetic response was 10% and 21%, respectively, and for patients without cytogenetic response, it was 46% and 60%. Patients with del(5q) myelodysplastic syndromes without erythroid or cytogenetic remission after treatment with lenalidomide have a high risk for clonal evolution and acute myeloid leukaemia progression. In refractory, or relapsing, patients, genetic instability and clonal evolution seem to be the driving forces of leukaemic transformation. Regular follow-up investigations of del(5q) myelodysplastic syndrome patients treated with lenalidomide may help to identify patients requiring alternative treatment strategies. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00277-009-0846-zAuthors Gudrun Göhring, Hannover Medical School Institute of Cell and Molecular Pathology Carl-Neuberg-Str. 1 30625 Hannover GermanyAristoteles Giagounidis, St. Johannes Hospital Department of Haematology, Oncology and Clinical Immunology Duisburg GermanyGuntram Büsche, Hannover Medical School Institute of Pathology Hannover GermanyHans Heinrich Kreipe, Hannover Medical School Institute of Pathology Hannover GermanyMartin Zimmermann, Hannover Medical School Department of Paediatric Haematology/Oncology Hannover GermanyEva Hellström-Lindberg, Karolinska University Hospital Division of Haematology and Centre of Experimental Haematology, Department of Medicine, Karolinska Institutet Stockholm SwedenCarlo Aul, St. Johannes Hospital Department of Haematology, Oncology and Clinical Immunology Duisburg GermanyBrigitte Schlegelberger, Hannover Medical School Institute of Cell and Molecular Pathology Carl-Neuberg-Str. 1 30625 Hannover Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555
Serum albumin level is a significant prognostic factor reflecting disease severity in symptomatic multiple myeloma
Wed, 21 Oct 2009 12:31:05 -0000
Abstract  Serum albumin level, in association with serum interleukin-6 level, is a significant prognostic factor in multiple myeloma patients. The aim of this study was to determine any clinical factors associated with decreased serum albumin level. We retrospectively reviewed the records of 373 patients diagnosed with multiple myeloma at the Asan Medical Center, Seoul, Korea, between January 1996 and March 2008. Patients were divided into two groups according to serum albumin level (above or below 3.5 g/dL, the prognostic cutoff value), and clinical parameters were compared between groups. We aimed to identify any clinical parameters associated with low serum albumin levels. The group with serum albumin <3.5 g/dL showed older patient age, lower hemoglobin level, and poorer performance status. By contrast, levels of serum beta2-microglobulin, serum M protein, and bone marrow plasma cells were significantly higher in the group with low serum albumin levels. No significant between-group differences were found when serum calcium and creatinine levels were compared. Numbers of cytogenetic abnormalities and lytic bone lesions also showed no significant between-group differences. In both univariate and multivariate analyses, serum albumin level less than 3.5 g/dL was identified as a significant pretreatment prognostic factor. Lower serum albumin levels in multiple myeloma patients are associated with clinical factors reflecting disease severity. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00277-009-0841-4Authors Jeong Eun Kim, University of Ulsan College of Medicine Department of Oncology, Asan Medical Center 86 Asan Byeongwon gil, Songpa-gu Seoul 138-736 South KoreaChanghoon Yoo, University of Ulsan College of Medicine Department of Oncology, Asan Medical Center 86 Asan Byeongwon gil, Songpa-gu Seoul 138-736 South KoreaDae Ho Lee, University of Ulsan College of Medicine Department of Oncology, Asan Medical Center 86 Asan Byeongwon gil, Songpa-gu Seoul 138-736 South KoreaSang-We Kim, University of Ulsan College of Medicine Department of Oncology, Asan Medical Center 86 Asan Byeongwon gil, Songpa-gu Seoul 138-736 South KoreaJung-Shin Lee, University of Ulsan College of Medicine Department of Oncology, Asan Medical Center 86 Asan Byeongwon gil, Songpa-gu Seoul 138-736 South KoreaCheolwon Suh, University of Ulsan College of Medicine Department of Oncology, Asan Medical Center 86 Asan Byeongwon gil, Songpa-gu Seoul 138-736 South Korea Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

American Journal of Hematology

Estimating platelet production in patients with HIV-related thrombocytopenia using the immature platelet fraction
Brian Garibaldi, Rupal Malani, Hsin-Chieh Yeh, Evan Lipson, Deborah Michell, Mosi Bennett, Alison Moliterno, Michael A. McDevitt, Thomas S. Kickler Fri, 09 Oct 2009 14:05:00 -0000
No abstract.
Cytoreductive therapy in 108 adults with systemic mastocytosis: Outcome analysis and response prediction during treatment with interferon-alpha, hydroxyurea, imatinib mesylate or 2-chlorodeoxyadenosine
Ken H. Lim, Animesh Pardanani, Joseph H. Butterfield, Chin-Yang Li, Ayalew Tefferi Fri, 09 Oct 2009 14:05:00 -0000
Cytoreductive therapy in systemic mastocytosis (SM) includes several drugs whose individual merit has not been well characterized. We retrospectively studied 108 Mayo Clinic patients who met the 2008 WHO diagnostic criteria for SM and received at least one cytoreductive drug. The numbers of patients who were evaluable for response to treatment with interferon-alpha with or without prednisone (IFN-[alpha]), hydroxyurea (HU), imatinib mesylate (IM) or 2-chlorodeoxyadenosine (2-CdA) were 40, 26, 22, and 22, respectively. The corresponding overall (major) response rates, according to recently published consensus criteria, were 53% (18%), 19% (0%), 18% (9%), and 55% (37%). The respective overall response rates in indolent SM, aggressive SM and SM associated with another clonal hematological nonmast cell lineage disease (SM-AHNMD) were 60%, 60%, 45% for IFN-[alpha], 0, 0, 21% for HU, 14%, 50%, 9% for IM and 56%, 50%, 55% for 2-CdA. The absence of mast cell mediator release symptoms in IFN-[alpha]-treated patients and presence of circulating immature myeloid cells in 2-CdA-treated patients predicted inferior response. TET2 mutational status did not influence treatment response. Although the major response rates with these four cytoreductive agents were still suboptimal and HU was mainly used in patients with SM-AHNMD, the current study favors 2-CdA or IFN-[alpha] as first-line current therapy in SM and identifies patients who are likely to respond to such therapy. Am. J. Hematol., 2009. © 2009 Wiley-Liss, Inc.
Relapsed or refractory nongastric marginal zone B-cell lymphoma: Multicenter retrospective analysis of 92 cases
Sung Yong Oh, Won Seog Kim, Seok Jin Kim, Jin Seok Kim, Sung-Hyun Kim, Dae Ho Lee, Jong-Ho Won, In Gyu Hwang, Min Kyoung Kim, Soon Il Lee, Jong Gwang Kim, Deok-Hwan Yang, Hye Jin Kang, Chul Won Choi, Jinny Park, Young Jin Choi, Hyo Jung Kim, Jung Hye Kwon, Cheolwon Suh, Hyo-Jin Kim Thu, 08 Oct 2009 11:45:00 -0000
Over its long survival duration, marginal zone B-cell lymphoma (MZL) routinely involves frequent relapses. In this study, we conducted a retrospective analysis to identify the clinical features and outcomes of relapsed or refractory MZL. From 1995 to 2008, a total of 92 patients with relapsed MZL were retrospectively analyzed. The median age of our subjects was 53.5 years (range: 23-82 years). The most common primary sites of involvement were the orbit and ocular adnexa (28.3%) followed by the lymph node and lymphatic organs (23.9%), and multiple mucosa-associated lymphoid tissue (MALT) sites (13.0%). The median time to relapse from initial diagnosis was 25.5 months. Of the 53 patients with Stage I or II at diagnosis, 42 patients (79.2%) evidenced locoregional recurrence. Among these locoregional relapsed patients, 27 patients achieved CR (54.1%) or PR (18.9%). In addition to the 39 patients initially in advanced Stage III or IV, a total of 50 patients were in advanced stage at relapse. Among those patients with advanced stage at relapse, 44 patients were treated. The overall response rate was 54.5% (24 patients), with 18 CRs and 6 PRs. The median time to progression (TTP) was 34.1 months (95% CI: 11.3-56.9 months) and the estimated 5-year overall survival (OS) was 84.3%. The majority of them was controlled well with salvage treatment, and could achieve prolonged survival. However, patients' refractory to initial therapy and advanced relapse evidenced shorter TTP and OS. Thus, we need to consider more aggressive treatment in cases of refractory MZL or advanced relapsed MZL. Am. J. Hematol., 2009. © 2009 Wiley-Liss, Inc.

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