Hematology is the medical discipline that studies and treats illnesses of the blood. The suspicion of a possible blood illness arises often when there are changes in the blood counts in laboratory testing of a blood sample. If a hematological illness is suspected, the patient is examined carefully with blood tests and bone marrow sampling. The samples are examined in laboratories specialized in blood diseases. Treatment is instituted rapidly after the diagnosis. The treatment of malignant blood diseases has developed extremely rapidly in the recent years and a major part of patients with malignant blood diseases can be cured with chemotherapy or stem cell transplantation.
There will be an individualized treatment plan for each patient, based on the most recent medical research results. The outcome of the treatment plan depends on the type of disease, the patient’s general condition, age and concomitant illnesses. This is why patients with the same hematological illness may have different treatment plans.
Malignant hematological diseases are treated with medicines, usually chemotherapy. Chemotherapy is a form of treatment with medicines given in courses. Courses may be provided by oral preparations (tablets), as intravenous infusions, as intramuscular injections, as subcutaneous injections or as injections into the spinal canal (intrathecally). Chemotherapy courses have usually a duration of 1–9 days, after which there is a break in medication of a few weeks before the next course.
Hematological illnesses may be treated, in addition to chemotherapy, with stem cell transplantation. A stem cell transplantation is a procedure by which stem cells collected from the circulating blood or from the bone marrow are given by infusion to the patient. Cells may be collected form the patient (autologous stem cell transplantation) or from a family member or unrelated voluntary compatible donor registered by the Finnish Red Cross (allogeneic stem cell transplantation). Cells for stem cell transplantation are primarily collected from the circulating blood. This is done at the department of hematology. The patient who undergoes stem cell transplantation is usually housed as a patient continuously for about four weeks in a row at the department of hematology. After treatment, follow-up continues meticulously, and the patient may need supportive treatments.
Hematological diseases and treatments increase the risk for infections, and thus we also treat various infections at the department of hematology. To avoid infection spread, patients with contagious infections are treated in isolation rooms for one person. Infections are usually treated with antibiotics administered intravenously and with symptomatic treatments, e.g., antipyretics (medicines that alleviate fever).
Hematological treatments may be associated with nausea and loss of appetite. There are effective drugs to combat nausea. The department of hematology strives also to fulfil the wishes of the patients regarding food preferences.
Many hematological illnesses and treatments may reduce blood counts. That is when blood transfusions are often needed. Providing blood products is one of the most important forms of supportive care at the department of hematology.
Hematological treatments may take a long time and the time spent in the hospital by the patient may be extensive. The diagnosis of a blood disease and the long treatments may be mentally distressing and affect the patient’s mental health. It is good for the patient to discuss the feelings caused by the illness and the treatments with the department personnel. When needed, support is also available from a psychiatric nurse, a psychiatrist or
the hospital chaplain.
Questions may arise regarding financial matters related to treatment costs and absenteeism from work. The social worker at the hospital is there to help in these matters. A physiotherapist and a dietician are also available, if needed, at the department of hematology.
After completion of treatment
After completion of the treatments including a possible stem cell transplantation, maintenance treatment may be needed, or the patient may be followed up. Follow-up and possible maintenance treatment may often be carried out at the health care center of the patient’s municipality. Follow-up is always designed for each patient separately by the physician.
Stem cell register (SPR, Finnish Red Cross)