Blood Disorder(Hematologic Disease)

Presented by :Jackie Peter D11A012

Khirrol Nizam D11A014Lee Joy Yoong D11A015

Types of Hematologic Disease

• Anaemias (presented by Josephin and Herlina)• Hemoglobinopathies (congenital abnormality of Hb or

Hb synthesis) • Cytopenia (decrease in no. of blood cells)• Myeloproliferative disease (increase in no. of blood

cells)• Coagulopathies (disorders of bleeding and coagulation• Hematological malignancies (cancer that affect blood,

bone marrow, or lymph nodes)• Hemochromatocies (hereditary disease that causes Fe

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Cytopenia and Hemoglobinopathies

JACKIE PETERD11A012

Outline

1. Cytopenia definition Types of Cytopenia Clinical correlations2. Hemoglobinopaties Definition, causes, examples Clinical correlations

1. CYTOPENIA

DEFINITION: Cytopenia is a reduction in the number of blood cells

TYPES OF CYTOPENIATypes EXPLAINATION

1. ANEAMIA LOW RBC COUNT

2. LEUKOPENIA/ NEUTROPENIA LOW WBC COUNT

3. TROMBOCYTOPENIA LOW PLATELET COUNT

4. GRANULOCYTOPENIA LOW GRANULOCYTE COUNT

5. PANCYTOPENIA LOW RBC, WBC AND PLATELET COUNT

CLINICAL CORRELATIONPANCYTOPENIA IN DOGS AND CATS

SYMPTOMS I. Low WBC Cell Count/Leukopenia/ Neutropenia repeated episodes of fever and frequent or persistent infections.ii. Anemia sluggishness and pale gums.iii. Low platelet count/ thrombocytopeniableeding from the moist tissues of the body, known as mucosal bleeding.

Diagnosis 1. physical exam a complete blood count, a chemical blood profile2. urine analysis3. bone marrow examination.

Treatments 1. Continuous antibiotic therapy and blood transfusions2. Medication that increase/ stimulateI. Production of WBCII. Production of RBC

2. HEMOGLOBINOPATHIES

DEF: congenital abnormality of the hemoglobin molecule or of the rate of hemoglobin synthesis

CAUSES production of abnormal hemoglobin deficiency of hemoglobin synthesis.

MAJOR EXAMPLES1. sickle cell disease 2. thalassemia.

Clinical correlationsHEMOGLOBINOPATHIES

1. SICKLE CELL ANAEMIA2. THALASSEMIA

Sickle cell anaemia

Sickle cell anaemia

Diagnosis A blood test can determine whether someone has a form of sickle cell disease or carries the sickle cell trait. Sickle cell disease usually is diagnosed at birth with a blood test during routine newborn screening tests. If a child tests positive on the screening test, a second blood test (called a hemoglobin electrophoresis) should be performed to confirm the diagnosis.

Sign and symptoms Inflammation, infection, and occlusion of small vessels may cause this syndrome. Signs include chest pain, coughing, difficulty breathing, and fever.

Can occur in animals? Can, but it is rarely to happen

Treatment Bone marrow transplant

Thalassemia

• Thalassemia describes a group of inherited disorders characterized by reduced or absent amounts of hemoglobin, the oxygen-carrying protein inside the red blood cells.

• β-thalassemia is an inherited disorder caused by mutations in the β-globin chain of haemoglobin that lead to ineffective production of red blood cells and profound anaemia

ThalassemiaTypes 1. Thalassemia minor

Only 1 beta globin bears mutation2. Thalassemia intermedia3. Thalassemia majorBoth alleles have thalassemia mutations

Symptoms A shortage of red blood cells (anemia), which can cause pale skin, weakness, fatigue, and more serious complications. People with beta thalassemia are at an increased risk of developing abnormal blood clots.

Treatment Bone marrow transplant

Can it occur in animals ?

Can but it is rarely.

Myeloproliferative disorder

&Coagulophaty

Myeloproliferative disorders

• A group of conditions that cause blood cells (platelets, white blood cells, and red blood cells) to grow abnormally in the bone marrow

• Increased numbers of cells• Myeloproliferative disorders include:– Polycythemia vera– Essential thrombocytosis– Primary or idiopathic myelofibrosis aka myelosclerosis– Chronic myelogenous leukemia (CML)

Myeloproliferative disorders

• Polycythemia vera - occurs when the bone marrow produces too many blood cells, especially red blood cells. More than 95% of people with polycythemia vera carry the blood mutation JAK2V617F.

• Essential thrombocytosis - occurs when the body produces too many platelet cells, which help blood to clot. Clots can block blood vessels leading to heart attack or stroke.

Myeloproliferative disorders

• Primary or idiopathic myelofibrosis aka myelosclerosis - occurs when the bone marrow produces too much collagen or fibrous tissue in the bone marrow. This reduces bone marrow's ability to produce blood cells

• Chronic myelogenous leukemia (CML) - cancer of the bone marrow that produces abnormal granulocytes, a type of white blood cell, in the bone marrow.

Myeloproliferative disorders

Causes• overproduction of one or more types of cells• Genetics - some people with CML have an

abnormally shortened chromosome known as the Philadelphia chromosome

• Environment - may result from an overexposure to radiation, electrical wiring, or chemicals

• Cats - commonly associated with Feline Leukemia Virus (FeLV) infection or from recovering from panleukopenia or hemobartonellosis infections

Myeloproliferative disorders

Symptoms• Lethargy• Weakness• Anemia• Recurrent infections• Pale mucous membranes• Weight loss• Enlargement of liver and spleen (except essential

thrombocytosis)

Myeloproliferative disordersDiagnosis• detect an enlarged spleen during a routine physical

examination• Blood tests - to find abnormal types or numbers of red or

white blood cells.• detect anemia and leukemia.• Bone marrow biopsy - sample of bone marrow may be taken

after blood tests. It can show the presence of abnormal types or numbers of red or white blood cells and may detect certain types of anemia and cancer in the marrow.

• Cytogenetic analysis - views blood or bone marrow are viewed under a microscope to look for changes in the chromosomes.

Myeloproliferative disorders

Treatment• Polycythemia vera - ower red blood cell count by removing

blood, called phlebotomy or treatment with medication, called myelosuppressive therapy

• Essential thrombocytosis - treat symptoms, when present, with medications

• Primary myelofibrosis - treat symptoms, when present, with medications and blood transfusion

• CML - targeted therapy, chemotherapy, biologic therapy, high-dose chemotherapy with stem cell transplant, donor lymphocyte infusion (DLI), surgery.

Coagulopathy• is a condition in which the blood’s ability to

clot is impaired• cause prolonged or excessive bleeding, which

may occur spontaneously or following an injury or medical and dental procedures

CoagulopathyCauses• missing or has low levels of one or more of clotting factors• platelet levels are low• Inherited or genetic disorders • Chronic disease, severe infection, and the use of certain medications• Anticoagulant drug use, such as heparin or warfarin (Coumadin)• Disseminated intravascular coagulation - serious disorder in which the

proteins that control blood clotting become abnormally active• Idiopathic thrombocytopenic purpura or thrombotic thrombocytopenic

purpura (rare conditions in which small blood clots form throughout the body, resulting in low platelet levels)

• Long-term use of antibiotics• Severe liver disease• Viral infection• Vitamin K deficiency

Coagulopathy

Symptomps• excessive bleeding that may occur

spontaneously or following an injury, surgery, or other incident

• Abnormal menstrual bleeding• Bleeding of the mouth and gums• Easy bleeding or bruising• Frequent nosebleeds

Coagulopathy

Treatments• draw blood samples for laboratory testing• Aminocaproic acid (Amicar), which prevents the breakdown of

blood clots and may be used to limit bleeding in the mouth during dental procedures

• Birth control (oral contraceptive) pills, which may help control excessive menstrual bleeding in women with coagulopathy

• Desmopressin acetate (DDVAP or Stimate), which may be used to release blood-clotting proteins stored in the body in cases of mild to moderate coagulopathy

• Plasma-derived factor concentrates and recombinant factor concentrates, which replace missing clotting factors

Hematological Malignancies

&Hemachromatocies

Hematological Malignancies

1) Myelomas2) Lymphomas3) Plasmacytoma4) Leukemias

MyelomaMyeloma- Cancer of plasma cells, where plasma cells

collection accumulate at bone marrow, interferes production of RBC.

- S & S : Hypocalcaemia (causes renal failure), bone pain at spine and ribs, lesions at bone, anaemia, immune deficiency

- Causes : damage to gene causes the loss of control to proliferation of B cells and secretion of plasma

Lymphomas

• Cancer of lymphocytes,• S & S : Anorexia, dyspnea, fatigue, fever (due

to unknown origin), itching, night sweats, lymphadenopathy

• By WHO, its divisible into : - B cell lymphomas- T cell lymphomas- NK cell lymphomas

Plasmacytoma

• Malignant plasma cell tumour growing within soft tissues (ST form) or within the skeleton (skeletal form)

• S & S : Paraproteinemia (excessive amount of single monoclonal gammaglobulin)

Treatment :• Skeletal form : Radiotherapy• Soft tissue form : Resection

Leukaemia's

• Type of cancers with abnormal increase of immature white blood cells

• S & S : Blood clotting mechanism disturbed, dysfunctional WBC, enlarged spleen and liver, frequent infection, WBC attack other body cells

• Divisible to : acute leukaemia and chronic leukaemia, myelogenous and lymphocytic

Definition

• Acute Leukemia : rapid increase in the numbers of immature blood cells.

• Chronic Leukemia : by the excessive build up of relatively mature, but still abnormal, white blood cells. Takes months or years to progress, the cells are produced at a much higher rate than normal, resulting in many abnormal white blood cells

Lymphocytic L. & Myelogenous

• Myelogenous : cancerous change takes place in a type of marrow cell that normally goes on to form red blood cells, some other types of white cells, and platelets

• Lymphocytic : cancerous change takes place in a type of marrow cell that normally goes on to form lymphocytes

Hemachromatocies

• iron overload with a hereditary/primary cause, or originating from a metabolic disorder

• S & S : cirrhosis (chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules), arthritis, joint and bone pain, testicular failure, tanning of skin, cardiomyopathy

Treatment

• Deferoxamine, deferasirox, deferiprone (chelating agent)

• Regular bloodletting (blood draws) by phlebotomies

Thank you ^^