New York Oncology, LLC
Disorders of Red Blood Cells
Hematology is the evaluation, diagnosis, and treatment of blood disorders. Your blood is
composed of several elements, including red blood cells, white blood cells, and platelets.
Evaluation often includes taking a thorough history, physical examination, specific hema-
tologic blood tests, and a review of the blood cells’ appearance with a microscope.
Occasionally, a more thorough examination of the blood cells is required. Then we per-
form a bone marrow aspirate/biopsy, which allows a closer look at where and how these
cells are produced. There are many types of hematologic or blood disorders and they fall
into several categories.
Red blood cells contain hemoglobin, the oxygen-carrying protein of the blood. Anemia
occurs when the red blood cell count is low and/or the hemoglobin concentration is low
or abnormal.
Interestingly, you can have a mild anemia and not have any symptoms. Patients with more
severe anemia may experience fatigue, lightheadedness, dizziness, palpitations, chest
pain, difficulty with breathing, pale skin, sore tongue, or jaundice. A diagnosis is often
made after a careful history, physical examination, and lab studies.
There are several forms of anemia. Most common are:
(a) Iron deficiency anemia is more often caused by blood loss. Secondary causes
include menstruation, or internal bleeding in the stomach or the intestines, which an
endoscopy or colonoscopy can help determine. Less commonly, iron deficiency may be
a result of diet. Without taking supplements, women may experience iron deficiency dur-
ing pregnancy. Step one in treatment is finding the source of blood loss and stopping it.
Step two may involve taking iron tablets. On rare occasions, an intravenous infusion may
be given.
(b) A B12 deficiency resulting in anemia may be caused by your gastrointestinal
tract’s inability to absorb the vitamin from your diet because of an immune or genetic dis-
order, surgery, or a medication you’re taking. A strict vegetarian diet may also be a cause.
Diagnosis and treatment is particularly important because this anemia may cause neuro-
logical problems. Treatments include B12 injections or oral replacement.
(c) Anemia from folate deficiency may be related to diet, inability to absorb nutri-
ents, pregnancy, red blood cell destruction, or medications. Treatments include oral
replacement with folic acid tablets; however, this should only be done under your physi-
cian’s guidance.
(d) Anemias of chronic disease, kidney disease, or cancers may all be due to insuf-
ficient production of, or response to, Erythropoietin, a hormone produced by the kidneys,
which helps stimulate production of red blood cells in bone marrow. Some diseases sup-
press its production, in which case your treatment may include erythropoietin injections.
(e) Hemolytic anemia occurs when red blood cells are destroyed, due to inherited
conditions, infection, medications, or an immune disorder. Evaluation and treatment
varies with the cause and condition.
(f) Finally, many other abnormal red blood cell or hemoglobin disorders may result
in anemia. Sickle cell anemia and thalassemia are two of the more common. Here, med-
ical follow-up and treatment often varies greatly depending on the type, and severity of
symptoms.
For more information, contact the doctors at New York Oncology, LLC,
1050 Park Avenue, New York, NY 10028. 212/860.3292.
(c) 2005 New York Oncology LLC