Clinical Haematology

General Services

Haematology is the branch of medicine that deals with the diagnosis and treatment of people with disorders of the blood and the bone marrow. While a haematologist spends most of his time delivering clinical care to patients, significant work has to be done in the laboratory to diagnose the disorders. To deliver optimum treatment, haematologists work closely with the experts of other departments such as oncologists, internists, and blood transfusion staff.

A wide range of laboratory investigations are performed by haematologists to prepare and interpret results. This helps the clinicians diagnose and treat a wide range of diseases and disorders. The investigations performed in the haematology department also supports other hospital departments like intensive care, accident and emergency, operating theatres, oncology, and special care baby units. For example, haematologists receive blood samples from surgeons, which they then check for abnormalities. They examine the blood film and if they suspect any abnormalities, such as leukaemia, they evaluate the patient, explain concerns, go for a bone marrow biopsy, and carefully assess the samples. This way the diagnosis can be established within a few hours. This is extremely important and significant for prognosis as in most cases, treatment needs to be started immediately.

Patients with different types of anaemia are also diagnosed and treated in the haematology department. A part of haematology also deals with transfusion medicine, the department that ensures adequate stocks of safe blood are available whenever blood transfusions are needed. In the department, it is confirmed which donated blood is appropriate for a certain patient based on his blood group and other blood characteristics. This way haematologists also provide vital support for blood transfusion, stem cell transplantation, and organ transplantation.

The Department of Clinical Haematology at Kokilaben Dhirubhai Ambani Hospital, Indore provides medical expertise and services related to the diagnosis, treatment, and prevention of haematological diseases and disorders in adults and children. Adequate facilities for undertaking chemotherapy and other therapeutic procedures are available in the department.

Following are some of the common disorders diagnosed and treated in the clinical haematology department:

Leukaemia

Leukaemia refers to the malignancy of the blood-forming tissues of the body, including the lymphatic system and the bone marrow. There are different types of leukaemia, some forms are more common in children while others mostly occur in adults.

Leukaemia commonly affects the white blood cells, which are potent fighters against disease and infections. They normally grow and multiply in an organised fashion, depending on the needs of the body. But, in patients of leukaemia, excessive amounts of abnormal white blood cells are produced in the bone marrow. These white blood cells don't function properly.

The treatment for complicated types of leukaemia can be complex and depends on many different factors. However, our experienced doctors use different resources and strategies to make the treatment successful.

Lymphoma

Lymphoma refers to the malignancy of the lymphatic system, a major part of the germ-fighting network of the body. Lymphatic system consists of the lymph nodes or lymphatic glands, thymus gland, spleen, and bone marrow. Lymphomas can involve all those areas as well as certain other organs throughout the body. There are many different types of lymphomas. Following are the main subtypes - Hodgkin's lymphoma or Hodgkin's disease.

The lymphoma treatment best suited to your condition depends on the type and severity of the disease you have. The treatment involves immunotherapy, chemotherapy, radiation therapy, and bone marrow transplant. A single treatment modality or a combination of multiple treatment modalities may be used depending on the nature of the disease, overall condition of the patient, and their personal preferences.

We at Kokilaben Dhirubhai Ambani Hospital, Indore acknowledge that cancer treatment may drastically affect patients, both physically and psychologically. So, in order to provide the best lymphoma treatment in Indore, we focus on providing the patients with both physical and emotional support during post-therapy follow-up visits. Supportive care therapies are used to manage common side effects include fatigue, nausea and vomiting, neuropathy, mouth sores, and depression. Patients with mental health issues receive post-treatment psychological and mental care from our team.

Myeloma

Multiple myeloma is a malignancy that develops in a form of white blood cell known as a plasma cell. Healthy plasma cells help fight infections by forming antibodies that identify, attack, and damage pathogens. In this condition, the malignant plasma cells accumulate in the bone marrow, crowding out the healthy blood cells.

Instead of producing helpful antibodies, the malignant cells release abnormal proteins that pave way for complications. Multiple myeloma doesn’t always require treatment right away. If the tumour is slow growing and does not cause any major symptoms, the doctors may suggest close monitoring instead of immediate intervention. For those with multiple myeloma requiring treatment, a number of options are available to control the disease and its symptoms.

Paediatric Hematopoietic disorders including Leukaemia/Lymphoma

Coagulation disorders

Coagulation disorders refers to conditions that adversely affect the clotting activities of the blood. Von Willebrand disease, haemophilia, hypercoagulable states, clotting factor deficiencies, and deep venous thrombosis are all coagulations disorders. Von Willebrand disease and haemophilia are the most common ones.

Haemophilia

Von Willebrand disease

Thrombotic disorders

Thrombosis is a serious condition resulting in the formation of one or more blood clots inside the blood vessels. When this occurs, the blood clot can result in blockage of blood flow at its location. It can also break loose and dislodge to some other location. If this occurs and the moving clot gets stuck in a sensitive area, this can lead to life-threatening consequences like heart attack and stroke. Thrombosis can affect people of all ages, but it is more common in older people. This condition also occurs more commonly if you have certain medical conditions like cancer, atrial fibrillation, diabetes, and heart disease.

The best you can do is try to prevent thrombosis, especially if you have some known risk factors for the disease. While this may not always be possible, taking necessary steps at the right time can make the condition less severe even if it occurs. Your chances of having a positive outcome also increase if you don’t delay getting medical treatment and care. Make sure to talk to your healthcare provider about any concerns, as it is best to gain as much information as possible about your situation.

Platelet disorders

Platelets are blood cells. They are also known as thrombocytes. They develop in the bone marrow, a sponge-like tissue present inside the bones. Platelets play a vital role in the process of blood clotting. Normally, injury to the blood vessel results in bleeding. This bleeding is stopped as the platelets clot and clump together to plug the site of injury and stop bleeding. Platelet disorders are of many different types, including:

Thrombocytopenia

Thrombocytopenia refers to a low platelet count in the blood. The condition can put the person at a risk for mild to severe bleeding. The bleeding can either occur externally or internally. There are various causes responsible for this condition. No treatment is required if the condition is mild. More serious cases require medications or platelet or whole blood transfusions.

If the blood contains too many platelets, the risk of forming blood clots is higher. When the cause of the condition is not known, it is referred to as thrombocytopenia. It is a relatively rare condition. No treatment is required if there are no signs and symptoms. Those who exhibit signs and symptoms may require treatment with procedures or medicines.

Thrombocytosis

If a condition or disorder is causing the platelet count to rise, it is called thrombocytosis. The outlook and treatment for thrombocytosis depends on its cause.

Abnormal platelets

Another potential problem is that the platelets don’t function properly. For example, in a condition called Von Willebrand disease, the platelets fail to stick together and attach to the walls of the blood vessels. This can lead to excessive bleeding. Von Willebrand disease is of different types. The treatment depends on what type you have.

Haemolytic anaemia

It is a blood disorder that generally occurs when the red blood cells disintegrate and die faster than the body is able to replace them with freshly made cells. Hemolytic anaemia may occur by inheriting genetic conditions resulting in anaemia, certain medications, and certain infections. This condition is treated by healthcare providers by treating the underlying issue.

Anaemia is of many different types. Haemolytic anaemia occurs when the red blood cells disintegrate or die faster than they normally should. The normal lifespan of red blood cells is around 120 days. When they die sooner than that, the bone marrow doesn’t get enough time to produce new red blood cells. This leaves the person with a low RBC count.

Other types of anaemias occur when:

  • Illness or injury results in excessive bleeding that drains the red blood cell supply at a faster rate than the body can replace it.
  • Something affects the production of red blood cells so that the body either produces less number of red blood cells or produces abnormal red blood cells.
  • Haemolytic anaemia is less common than that caused by slow red cell production or excessive bleeding.
  • Haemolytic anaemia occurs when something destroys the red blood cells. This condition may be a sign that you have a medical issue caused by infection or an inherited medical condition. It can also mean that your body is reacting to certain medications. Whatever the cause, your healthcare provider focuses on determining and treating it. Timely treatment often means the difference between getting better and getting worse. The symptoms of haemolytic anaemia may appear similar to those caused by less serious conditions.

White cell disorders

White blood cells or leukocytes are the main cells constituting the immune system. They protect the body against allergens, infectious diseases, and other foreign invaders. The white blood cell count in the blood can often help a healthcare provider determine the presence of a disease. The normal white blood cell count is usually between 4,000-11,000 cells/ml of blood. Having an increased white blood cell count is known as leukocytosis and having a reduced count is known as leukopenia.

White blood cells are of many different types, with each type responsible for a specific job. Two main types of white blood cells are leukopenia and proliferative disorders. Proliferative disorders are characterised by an increase in white blood cell count. This increase commonly occurs due to infections but may also be related to certain types of malignancies.

Leukopenia are characterised by a decrease in white blood cell count which can occur when white blood cells get destroyed by an illness or any other condition. A particular type of leukopenia is neutropenia, which is characterised by a fewer number of neutrophils in the blood. Other causes of neutropenia include medications, chemotherapy, viral illness, and toxins. Disorders that can give rise to neutropenia within the body include bone marrow defects or conditions where a person has had too few neutrophils since birth.

Both neutropenia and leukopenia can result in immune system deficiency, which can enhance infection risk. Treatment of neutropenia and leukopenia are aimed at correcting the underlying cause of the cell count change. As mentioned earlier, an increase in white blood cell count in the circulation is known as leukocytosis. It can occur due to inflammation and other disorders that result in an increased production of bone marrow, release of too many white blood cells at once from the bone marrow, or disorders that prevent the attachment of white blood cells to tissues and their absorption by the tissues of the body.

Haemoglobinopathies

Haemoglobinopathies are genetic disorders that alter the haemoglobin structure. The result is a decreased oxygen-carrying capacity of the blood and less blood reaching the tissues. Following are different types of haemoglobinopathies:

  • sickle cell trait (HbAS)
  • sickle cell-thalassaemia (HbS and HbA)
  • sickle cell disease (HbS)
  • sickle cell-haemoglobin C (HbSC)
  • alpha thalassaemia (deficient alpha-globin chain synthesis)
  • thalassaemia major (homozygous) - Cooley anaemia
  • beta thalassaemia (deficient beta-globin chain synthesis)
  • thalassaemia minor (heterozygous)
  • haemoglobin C trait (HbAC).
  • haemoglobin C disease (HbCC)

The signs and symptoms of haemoglobinopathies vary from one person to another as they depend on many different factors including the type of the disease and the overall condition of the patient. Some common signs and symptoms include tachycardia, claudication, vertigo, dyspnoea, and angina.

Red cell disorders – Anaemia, Polycythemia etc.

Kokilaben Dhirubhai Ambani Hospital's haematologists use advanced diagnostic techniques and treatments to treat haematological diseases in the best way. The best haematologists in Indore will discuss all the suitable treatment options with you. Together, you will be selecting the approach that best suits your situation. For many patients, that might mean selecting minimally invasive procedures developed at Kokilaben Dhirubhai Ambani Hospital, Indore that produce excellent outcomes and rapid recovery.

Haematological services at Kokilaben Dhirubhai Ambani Hospital, Indore include treatment for a wide range of haematological conditions like haemophilia, Von Willebrand disease, iron deficiency anaemia, haemolytic anaemia, aplastic anaemia, Thalassemia, leukaemia, multiple myeloma, and Hodgkin and non-Hodgkin lymphoma. When you come to Kokilaben Dhirubhai Ambani Hospital, Indore you are taken care of by one of the best haematologists in Indore who are committed to delivering advanced surgical care at the hospital's campus in Indore.