Haematology is the study of blood, blood-forming organs, and blood diseases. Hematologists complete medical school and residency training before specializing in diagnosing and treating disorders like anemia, blood cancers, and bleeding disorders. Some key responsibilities of hematologists include understanding abnormalities in blood formation, diagnosing issues through lab tests, and managing care for patients with blood diseases. Common diseases treated include leukemia, myeloma, sickle cell anemia, and disorders affecting platelets or coagulation like hemophilia.

2. What is haematology ?
Haematology is a branch of medicine concerning the study of
blood, the blood-forming organs, and blood diseases.
The word "heme" comes from the Greek for blood.
Scope of haematology
Haematology is practised by specialists in the field who deal
with the diagnosis, treatment and overall management of people
with blood disorders ranging from anemia to blood cancer.

3. Training and work
• Physicians working in the field of hematology are
called hematologists.
• Initially, hematologists complete a four-year
medical degree and this is followed by three or
four years in an internship or residency program.
• Thereafter, they spend two or three more years
learning how to diagnose and treat blood disorders.
• B.Sc (Clinical Lab Technology)
• M.Sc (Medical Lab technology)
• DMLT
• PGDCLT

4. Extensive, first-hand practical experience in a
recognised training centre provides hematologists with
expertise in the following areas:
• The cause of abnormalities in blood formation and
other blood disorders
• The diagnosis of various blood related disorders and
cancers using laboratory tests and workups
• The care and treatment of patients with blood
diseases or hematological diseases

5. Some of the diseases treated by haematologists include:
• Iron deficiency anaemia and other types of anaemia such as sickle cell anaemia or
trauma-related anaemia
• Polycythaemia or excess production of red blood cells
• Myelofibrosis
• Leukaemia
• Platelet and bleeding disorders such as haemophilia, idiopathic thrombocytopenic
purpura and Von Willebrand disease
• The myelodysplastic syndromes
• Hemoglobinopathies such as thalassemia and sickle cell disease
• Multiple myeloma
• Malignant lymphomas
• Blood transfusion
• Bone marrow stem cell transplantation

6. SICKLE CELL
ANAEMIA

7. SICKLE CELL ANAEMIA
• Sickle cell anaemia is one of a group of inherited disorders known as
sickle cell disease.
• It affects the shape of red blood cells, which carry oxygen to all parts
of the body.
• Red blood cells are usually round and flexible, so they move easily
through blood vessels. In sickle cell anemia, some red blood cells are
shaped like sickles or crescent moons.
• These sickle cells also become rigid and sticky, which can slow or block
blood flow.
• There's no cure for most people with sickle cell anemia.
• Treatments can relieve pain and help prevent complications associated
with the disease.

9. Signs and symptoms
Signs and symptoms of sickle cell anemia usually appear around 6 months of age. They vary
from person to person and may change over time. Signs and symptoms can include:
• Anemia
• Episodes of pain
• Swelling in hands and feet
• Frequent infections
• Delayed growth or puberty
• Vision problems
Causes
Sickle cell anemia is caused by a change in the gene that tells the body to make the iron-rich
compound in red blood cells called hemoglobin. Hemoglobin enables red blood cells to carry
oxygen from the lungs throughout the body. The hemoglobin associated with sickle cell anemia
causes red blood cells to become rigid, sticky and misshapen. For a child to be affected, both
mother and father must carry one copy of the sickle cell gene — also known as sickle cell trait
— and pass both copies of the altered form to the child.

10. If only one parent passes the sickle cell gene to the child, that child will have the
sickle cell trait. With one typical hemoglobin gene and one altered form of the
gene, people with the sickle cell trait make both typical hemoglobin and sickle cell
hemoglobin.
Their blood might contain some sickle cells, but they generally don't have
symptoms. They're carriers of the disease, however, which means they can pass the
gene to their children.
Risk factors
For a baby to be born with sickle cell anemia, both parents must carry a sickle cell
gene. In the United States, sickle cell anemia most commonly affects people of
African, Mediterranean and Middle Eastern descent.

11. Complications
Sickle cell anemia can lead to a host of complications, including:
• Stroke
• Acute chest syndrome
• Pulmonary hypertension
• Organ damage
• Blindness
• Leg ulcer
• Splenic sequestration
• Gall stones
• Pregnancy complications
• Priapism
• Deep vein thrombosis

12. Prevention
If you carry the sickle cell trait, seeing a genetic counselor before
trying to conceive can help you understand your risk of having a
child with sickle cell anemia.
A genetic counselor can also explain possible treatments, preventive
measures and reproductive options.

13. POLYCYTHAEMIA

14. POLYCYTHEMIA
• Polycythemia refers to an increase in the number of red blood
cells in the body.
• The extra cells cause the blood to be thicker, and this, in
turn, increases the risk of other health issues, such as blood
clots.
• Polycythemia can have different causes, each of which has its
own treatment options. The treatment of polycythemia
involves treating any underlying conditions, if possible, and
finding ways to bring blood cell levels down.

15. Types of polycythemia
There are two types of polycythemia, which have different causes.
1. Primary polycythemia
• Primary polycythemia is also called polycythemia vera (PV).
• PV is a rare, slow growing blood cancer that is a type of condition known as a
myeloproliferative neoplasm.
• PV causes the bone marrow to create excess precursor blood cells that develop and
function abnormally, leading to the production of too many red blood cells.
• A person with PV may also have increased numbers of other blood cells, such as white
blood cells or platelets.

16. 2. Secondary polycythemia
• Secondary polycythemia can occur if the increase in red blood cells is not due
to the myeloproliferative disease of PV.
• The overproduction of blood cells in secondary polycythemia is limited to the
red blood cells.
Causes of secondary polycythemia
• being at a very high altitude
• obstructive sleep apnea
• certain types of tumor
• heart or lung disease that causes a low oxygen level in the body

17. Risk factors
• Some people may be more at risk than others of primary polycythemia. The National
Center for Advancing Translational Science note that most cases of PV appear as a
person ages, usually around the age of 60 years.
• They also note that it is more common in men than in women.
• PV is not necessarily hereditary, and most people with the disease do not have a family
history of PV.
• However, there appears to be a connection to a certain genetic mutation.
• The Leukemia & Lymphoma Society note that almost all individuals with PV have a
mutation in the Janus kinase 2 (JAK2) gene.
• However, the precise role that it plays in the condition is still unclear.
• Other gene mutations, such as that of the TET2 gene, may also have an association
with this condition.
• Most of the time, these genes are not hereditary, but in some rare cases, they may
pass from a parent to their child in the sperm or egg.
• Anyone with a family history of PV may still wish to see a doctor for an evaluation.

18. SYMPTOMS
• dizziness or vertigo
• headaches
• excessive sweating
• itchy skin
• ringing in the ears
• blurred vision
• fatigue
• reddish or purplish skin on the palms, earlobes, and nose
• bleeding or bruising
• a burning sensation in the feet
• abdominal fullness
• frequent nosebleeds
• bleeding gums

19. COMPLICATIONS
• enlarged spleen
• blood clots
• angina
• stroke
• peptic ulcers
• heart disease
• gout
• other blood disorders, such as myelofibrosis or
leukaemia

20. Diagnosis
If doctors suspect that a person has polycythemia, they will order several tests to help identify
the underlying issue.
1. Blood tests
Blood tests, such as a complete blood count, will reveal any increase in red blood cells in the
bloodstream, as well as any abnormal levels of platelets and white blood cells. If PV seems
possible, a doctor will order more specific blood tests.
2. Bone marrow biopsy
If necessary, the doctor may also want to remove some bone marrow on which to perform tests
in a lab.A bone marrow biopsy involves taking a small sample of the bone marrow with a needle
for examination under a microscope.
3. Genetic tests
Although genetic causes of PV are more rare, doctors may also want to analyze the person’s
bone marrow for genetic mutations that have links to PV.They may also recommend examining
cells in the blood for JAK2 mutation

21. Treatment
Treatment for polycythemia will depend on the underlying cause of the condition.
In people with secondary polycythemia resulting from causes such as obstructive sleep
apnea, treating the underlying cause should help resolve the high red blood cell count.
PV, however, is a chronic condition that has no known cure. The treatment for PV aims
to manage the condition by reducing both the red blood cell count and the risk of
complications, such as blood clots. If the platelet count is too high, there are ways to
treat this as well.
Treatment options for PV can include:
Phlebotomy
To help manage the condition, doctors will look to reduce the red blood cell count
through a process called phlebotomy, which manually removes blood through one of the
veins.
Depending on the individual case, doctors will recommend removing a certain amount of
blood at set intervals to get the red blood cell count closer to normal levels.

22. Drugs to reduce blood cells
Sometimes, phlebotomy is not enough to control blood cell growth. Doctors
may then recommend myelosuppressive drugs to help control blood cell
counts.
These drugs include hydroxyurea (Hydrea), which suppresses the bone marrow
to keep it from producing as many blood cells.
JAK2 inhibitors
In cases where a person does not respond well to other medications, doctors
may recommend drugs that inhibit the JAK2 enzyme, which the JAK2 gene
is responsible for producing. These include ruxolitinib (Jakafi).
Other medications
Doctors will also often recommend other drugs to help control symptoms.
These include aspirin and antihistamines. Taking low dose aspirin helps reduce
the risk of clotting in many people with PV, and it may also alleviate
troubling symptoms, such as headaches. Doctors may recommend
antihistamine drugs to help relieve itchiness.

23. LEUKEMIA

24. What is leukemia?
• Leukemia is cancer of the body's blood-forming tissues, including the
bone marrow and the lymphatic system.
• Many types of leukemia exist. Some forms of leukemia are more
common in children. Other forms of leukemia occur mostly in adults.
• Leukemia usually involves the white blood cells.
• Your white blood cells are potent infection fighters — they normally
grow and divide in an orderly way, as your body needs them.
• But in people with leukemia, the bone marrow produces an excessive
amount of abnormal white blood cells, which don't function properly.
• Treatment for leukemia can be complex — depending on the type of
leukemia and other factors.
• But there are strategies and resources that can help make your
treatment successful.

25. Symptoms
Leukemia symptoms vary, depending on the type of leukemia. Common leukemia
signs and symptoms include:
• Fever or chills
• Persistent fatigue, weakness
• Frequent or severe infections
• Losing weight without trying
• Swollen lymph nodes, enlarged liver or spleen
• Easy bleeding or bruising
• Recurrent nosebleeds
• Tiny red spots in your skin (petechiae)
• Excessive sweating, especially at night
• Bone pain or tenderness

26. How leukemia forms ?
• In general, leukemia is thought to occur when some blood cells
acquire changes (mutations) in their genetic material or DNA.
• A cell's DNA contains the instructions that tell a cell what to
do. Normally, the DNA tells the cell to grow at a set rate and
to die at a set time.
• In leukemia, the mutations tell the blood cells to continue
growing and dividing.
• When this happens, blood cell production becomes out of
control.
• Over time, these abnormal cells can crowd out healthy blood
cells in the bone marrow, leading to fewer healthy white blood
cells, red blood cells and platelets, causing the signs and
symptoms of leukemia.

27. TYPES OF LEUKEMIA
The first type of classification is by how fast the leukemia progresses:
1. Acute leukemia. In acute leukemia, the abnormal blood cells are immature blood cells
(blasts). They can't carry out their normal functions, and they multiply rapidly, so the disease
worsens quickly. Acute leukemia requires aggressive, timely treatment.
2. Chronic leukemia. There are many types of chronic leukemias. Some produce too many cells
and some cause too few cells to be produced. Chronic leukemia involves more-mature blood
cells. These blood cells replicate or accumulate more slowly and can function normally for a
period of time. Some forms of chronic leukemia initially produce no early symptoms and can go
unnoticed or undiagnosed for years.
The second type of classification is by type of white blood cell affected:
1. Lymphocytic leukemia. This type of leukemia affects the lymphoid cells (lymphocytes), which
form lymphoid or lymphatic tissue. Lymphatic tissue makes up your immune system.
2. Myelogenous (my-uh-LOHJ-uh-nus) leukemia. This type of leukemia affects the myeloid
cells. Myeloid cells give rise to red blood cells, white blood cells and platelet-producing cells.

28. The major types of leukemia are:
1. Acute lymphocytic leukemia (ALL). This is the most common type of leukemia in
young children. ALL can also occur in adults.
2. Acute myelogenous leukemia (AML). AML is a common type of leukemia. It
occurs in children and adults. AML is the most common type of acute leukemia in
adults.
3. Chronic lymphocytic leukemia (CLL). With CLL, the most common chronic adult
leukemia, you may feel well for years without needing treatment.
4. Chronic myelogenous leukemia (CML). This type of leukemia mainly affects
adults. A person with CML may have few or no symptoms for months or years
before entering a phase in which the leukemia cells grow more quickly.
5. Other types. Other, rarer types of leukemia exist, including hairy cell leukemia,
myelodysplastic syndromes and myeloproliferative disorders.

29. Risk factors
Factors that may increase your risk of developing some types of leukemia
include:
1. Previous cancer treatment. People who've had certain types of
chemotherapy and radiation therapy for other cancers have an increased risk
of developing certain types of leukemia.
2. Genetic disorders. Genetic abnormalities seem to play a role in the
development of leukemia. Certain genetic disorders, such as Down syndrome,
are associated with an increased risk of leukemia.
3. Exposure to certain chemicals. Exposure to certain chemicals, such as
benzene — which is found in gasoline and is used by the chemical industry —
is linked to an increased risk of some kinds of leukemia.
4. Smoking. Smoking cigarettes increases the risk of acute myelogenous
leukemia.
5. Family history of leukemia. If members of your family have been diagnosed
with leukemia, your risk of the disease may be increased.

30. BLEEDING DISORDER

31. What id bleeding disorder ?
• A bleeding disorder, sometimes called a coagulopathy,
is a condition that makes you more likely to bleed
than the average person.
• The body cannot form a clot properly. This involves
one of the parts of our coagulation (bleeding and
clotting) system.
• The coagulation system should be in balance—not too
much bleeding but also not too much clotting.
• One part of the process involves the platelets, a
type of blood cell.
• The second part is found in the liquid portion of
blood, called coagulation factors. People sometimes
refer to people with bleeding disorders as
“free bleeders.”

32. SYMPTOMS
• Frequent or prolonged nosebleeds
• Recurrent or prolonged bleeding of the
gums
• Excessive menstrual periods referred to
as menorrhagia as well as
excessive bleeding postpartum (after
delivery)
• Prolonged bleeding after a needle stick
(blood draw or injection like a vaccine)
• Excessive bleeding during or after surgery
that requires additional efforts to
stop bleeding
• Large palpable bruises

33. Causes
• Inherited: Some bleeding disorders like hemophilia and Von Willebrand disease are inherited,
meaning the person is born with the disease.
• Liver disease: The coagulation factors are made predominantly in the liver. People with
severe liver disease are unable to produce enough coagulation factors and therefore are
more likely to experience bleeding.
• Vitamin K deficiency: Several of the coagulation factors require vitamin K to function
correctly so people who are vitamin K deficient are more likely to have bleeding.
• Anticoagulation therapy: People on anticoagulation therapy (medications that prevent
clotting) are at increased risk of bleeding.
• Platelet disorders: If the platelets cannot function properly, they cannot form a proper
clot, which may result in bleeding.

34. Types of Bleeeding disorders
1. Hemophilia:
• Probably the most well known bleeding disorder is hemophilia.
• People with hemophilia are missing one of their coagulation
factors.
• The name of their type of hemophilia depends on what factor
is missing.
• The most common type is hemophilia A; these patients are
missing factor 8 from their coagulation system.
• There is also hemophilia B (factor 9 deficiency)1 and hemophilia
C (factor 11 deficiency).
• Hemophilia is inherited (passed down in families).
• It involves the Y chromosome so men are predominantly
affected.
• People with hemophilia can have significant bleeding
from injuries or spontaneous (without injury) bleeding.

35. 2. Von Willebrand disease:
• Von Willebrand disease (VWD) is the most common bleeding disorder in the world.
• It is estimated that 1% of the population has some form of Von Willebrand disease.
• VWD is also inherited but both men and women can be equally affected.
• The amount of bleeding can vary greatly depending on what type of VWD a person inherits.
3. Liver disease:
• When the liver is not functioning properly, it is unable to produce coagulation factors.
• Without these factors, patients can have significant bleeding.
4. Low platelet count (thrombocytopenia):
• There are numerous reasons for why the platelet count is low including leukemia, a side
effect of chemotherapy, and immune thrombocytopenia (where the immune system
destroys the platelets).
5. Platelet function disorders:
• In addition to low platelet numbers causing bleeding, if the platelets do not function
properly, bleeding may occur

36. TREATMENT
1. Factor replacement: Patients with hemophilia can infuse themselves with
factor replacement products that can treat bleeding episodes. Nowadays, many patients
with hemophilia infuse factor replacements on a regular basis to prevent bleeding episodes.
2. Desmopressin (also identified by the brand name Stimate): Desmopressin is a replacement
product for the hormone vasopressin. Taking desmopressin results in a temporary increase
in von Willebrand antigen and factor 8 which may stop bleeding in patients with
mild hemophilia A or von Willebrand disease.
3. Platelet transfusions: If the platelet count is low or the platelets do not
function correctly, a platelet transfusion may be given to prevent/treat bleeding.
4. Fresh frozen plasma: Coagulation factors are found in the plasma (liquid component
of blood). If a person is missing several different factors, like in liver failure, an infusion
of fresh frozen plasma can be given.
5. Vitamin K: If a patient if Vitamin K deficient, supplementation can be given.
6. Antifibrinolytics: These medications prevent excessive bleeding by stabilizing clots. These
are primarily used to control bleeding in the mouth or heavy menstrual periods.

37. MULTIPLE MYELOMA

38. What is multiple myeloma?
• Multiple myeloma also known as Kahler's disease, is a type of blood cancer.
• There's no cure, but treatments can slow its spread and sometimes make symptoms go
away.
• A type of white blood cell called a plasma cell makes antibodies that fight infections in
your body.
• When you have multiple myeloma, these cells multiply the wrong way.
• They let too much protein (called immunoglobulin) into your bones and blood.
• It builds up throughout your body and damages your organs.
• The plasma cells crowd out regular blood cells in your bones.
• They also send out chemicals that trigger other cells to eat away at your bones.
• The weak areas that this creates in your bones are called lytic lesions.
• As multiple myeloma gets worse, the plasma cells spill out of your bone marrow and
spread. This causes more organ damage.

40. Multiple Myeloma Causes and Risk Factors
Experts aren't sure what causes multiple myeloma. But you're more likely to get it if:
• You're older than 65
• You're male
• You're African American
• You have a family member with it
• You're overweight or obese
• You've been exposed to radiation
• You've had contact with chemicals used in rubber manufacturing, woodworking, or
firefighting; or in herbicides

41. Multiple Myeloma Symptoms
Early on, you might not notice any symptoms. But over time,
you may have:
• Bone pain
• Weakness and fatigue
• Weight loss and loss of appetite
• Upset stomach
• Constipation
• Confusion
• Frequent infections
• Severe thirst
• Weakness or numbness in your arms and legs

42. Multiple Myeloma Complications
Multiple myeloma can cause problems including:
1. Bone problems. Your bones can become weaker, leading to fractures.
2. Blood problems. You might get anemia, which means your body doesn't have
enough red blood cells. This can make you tired and pale and cause heart
problems. You might also have too few platelets, which makes it harder for
your blood to clot.
3. Infections. When you have myeloma, your body produces a lot of weak
antibodies that crowd out healthy ones, making it harder for you to fight
infection. A lack of white blood cells can also weaken your immune system.
4. Kidney damage. Myeloma can clog your kidneys so they don't filter the way
they should. This might lead to kidney failure.

43. Multiple Myeloma Diagnosis
Your doctor may suspect multiple myeloma if you have a blood test for something else and it
shows:
• Too much calcium in your blood (hypercalcemia)
• Too few red blood cells (anemia)
• Kidney problems
• High total protein levels in your blood, but low levels of one called albumin.
To confirm a diagnosis, you might have blood tests including:
1. A complete blood count (CBC). It measures the different kinds of cells in your blood.
2. Blood urea nitrogen (BUN) and creatinine. These check how well your kidneys are working.
Other blood and urine tests check whether your body is making unusual proteins and, if so,
what kinds and how much.

44. Multiple Myeloma Treatment
• Doctors grade multiple myeloma cases as high,
intermediate, or standard risk, based on genes in the
tumors.
• If you don't have symptoms, your doctor may choose to
watch you closely rather than start treatment right away.
• If you have symptoms, your doctor will work with you to
come up with a treatment plan. It will aim to improve
your quality of life by making you feel better and helping
you get enough nutrition.
• If your case is high-risk, you might consider joining a clinical
trial for an existing or new treatment. Research is looking
for more effective drugs.

45. BLOOD TRANSFUSION

46. What is blood transfusion ?
• A blood transfusion is a routine medical procedure in which donated blood is
provided to you through a narrow tube placed within a vein in your arm.
• This potentially life-saving procedure can help replace blood lost due to
surgery or injury.
• A blood transfusion also can help if an illness prevents your body from
making blood or some of your blood's components correctly.
• Blood transfusions usually occur without complications. When complications
do occur, they're typically mild.

48. Why it's done?
People receive blood transfusions for many reasons — such as surgery, injury, disease
and bleeding disorders.
Blood has several components, including:
• Red cells carry oxygen and help remove waste products
• White cells help your body fight infections
• Plasma is the liquid part of your blood
• Platelets help your blood clot properly
A transfusion provides the part or parts of blood you need, with red blood cells being
the most commonly transfused. You can also receive whole blood, which contains all
the parts, but whole blood transfusions aren't common.

49. How you prepare ?
Your blood will be tested before a transfusion to determine whether your blood type is
A, B, AB or O and whether your blood is Rh positive or Rh negative. The donated
blood used for your transfusion must be compatible with your blood type.
Tell your health care provider if you've had a reaction to a blood transfusion in the
past.
What you can expect ?
Blood transfusions are usually done in a hospital, an outpatient clinic or a doctor's
office. The procedure typically takes one to four hours, depending on which parts of the
blood you receive and how much blood you need.
Before the procedure
In some cases, you can donate blood for yourself before elective surgery, but most
transfusions involve blood donated by strangers. An identification check will ensure you
receive the correct blood.

50. During the procedure
An intravenous (IV) line with a needle is inserted into one of your blood vessels. The donated
blood that's been stored in a plastic bag enters your bloodstream through the IV. You'll be seated
or lying down for the procedure, which usually takes one to four hours.
A nurse will monitor you throughout the procedure and take measures of your blood pressure,
temperature and heart rate. Tell the nurse immediately if you develop:
• Fever
• Shortness of breath
• Chills
• Unusual itching
• Chest or back pain
• A sense of uneasiness

51. After the procedure
The needle and IV line will be removed. You might develop a bruise around the needle site,
but this should go away in a few days.
Contact your health care provider if you develop shortness of breath or chest or back pain
in the days immediately following a blood transfusion.
Results
You might need further blood testing to see how your body is responding to the donor
blood and to check your blood counts.
Some conditions require more than one blood transfusion.

52. Bloodborne infections
Blood banks screen donors and test donated blood to reduce the risk of transfusion-related
infections, so infections, such as HIV or hepatitis B or C, are extremely rare.
Other serious reactions
Also rare, these include:
1. Acute immune hemolytic reaction. Your immune system attacks the transfused red blood cells
because the donor blood type is not a good match. The attacked cells release a substance
into your blood that harms your kidneys.
2. Delayed hemolytic reaction. Similar to an acute immune hemolytic reaction, this reaction
occurs more slowly. It can take one to four weeks to notice a decrease in red blood cell
levels.
3. Graft-versus-host disease. In this condition, transfused white blood cells attack your bone
marrow. Usually fatal, it's more likely to affect people with severely weakened immune
systems, such as those being treated for leukemia or lymphoma.

53. BONEMARROW
STEM CELL TRANSPLANTATION

54. What is bonemarrow transplantation ?
• A bone marrow transplant is a procedure that infuses healthy blood-forming
stem cells into your body to replace your damaged or diseased bone marrow.
• A bone marrow transplant is also called a stem cell transplant.
• You might need a bone marrow transplant if your bone marrow stops working
and does not produce enough healthy blood cells.
• Bone marrow transplants may use cells from your own body (autologous
transplant) or from a donor (allogeneic transplant).
Why it's done ?
A bone marrow transplant may be used to:
• Safely allow treatment of your condition with high doses of chemotherapy or
radiation by replacing or rescuing the bone marrow damaged by treatment
• Replace diseased or damaged marrow with new stem cells
• Provide new stem cells, which can help kill cancer cells directly.

56. Bone marrow transplants can benefit people with a variety of both cancerous (malignant)
and noncancerous (benign) diseases, including:
• Acute leukaemia
• Adrenoleukodystrophy
• Aplastic anaemia
• Bone marrow failure syndromes
• Chronic leukaemia
• Hemoglobinopathies
• Hodgkin's lymphoma
• Immune deficiencies
• Inborn errors of metabolism
• Multiple myeloma
• Myelodysplastic syndromes
• Neuroblastoma
• Non-Hodgkin's lymphoma
• Plasma cell disorders
• POEMS syndrome
• Primary amyloidosis

57. RISKS
Possible complications from a bone marrow transplant
include:
• Graft-versus-host disease (allogeneic transplant
only)
• Stem cell (graft) failure
• Organ damage
• Infections
• Cataracts
• Infertility
• New cancers
• Death

58. How you prepare ?
Pretransplant tests and procedures
You'll undergo a series of tests and procedures to assess your general health and
the status of your condition, and to ensure that you're physically prepared for
the transplant.
The evaluation may take several days or more.
In addition, a surgeon or radiologist will implant a long thin tube (intravenous
catheter) into a large vein in your chest or neck.
The catheter, often called a central line, usually remains in place for the duration
of your treatment.
Your transplant team will use the central line to infuse the transplanted stem
cells, medications and blood products into your body.

59. Collecting stem cells for autologous transplant
• If a transplant using your own stem cells (autologous
transplant) is planned, you'll undergo a procedure called
apheresis to collect blood stem cells.
• Before apheresis, you'll receive daily injections of growth
factor to increase stem cell production and move stem
cells into your circulating blood so that they can be
collected.
• During apheresis, blood is drawn from a vein and
circulated through a machine. The machine separates
your blood into different parts, including stem cells.
These stem cells are collected and frozen for future use
in the transplant. The remaining blood is returned to
your body.

60. Collecting stem cells for allogeneic transplant
• If you're having a transplant using stem cells from a donor
(allogeneic transplant), you will need a donor.
• Once a donor is found, stem cells are gathered from that
person for the transplant.
• Stem cells can come from your donor's blood or bone marrow.
Your transplant team decides which is better for you based on
your situation.
• Another type of allogeneic transplant uses stem cells from the
blood of umbilical cords (cord blood transplant).
• Mothers can choose to donate umbilical cords after their babies'
births.
• The blood from these cords is frozen and stored in a cord blood
bank until needed for a bone marrow transplant.

61. CONDITIONING
After you complete your pretransplant tests and procedures, you begin a process known as
conditioning. During conditioning, you'll undergo chemotherapy and possibly radiation to:
• Destroy cancer cells if you are being treated for a malignancy
• Suppress your immune system
• Prepare your bone marrow for the new stem cells
Side effects of the conditioning process can include:
• Nausea and vomiting
• Diarrhea
• Hair loss
• Mouth sores or ulcers
• Infection
• Bleeding
• Infertility or sterility
• Anemia
• Fatigue
• Cataracts
• Organ complications, such as heart, liver or lung
failure

62. DIET AND LIFESTYLE FACTORS
Following food safety guidelines to prevent foodborne infections
• Eating a wide variety of healthy foods, including vegetables; fruits; whole grains;
lean meats, poultry and fish; legumes; and healthy fats, such as olive oil
• Limiting salt intake
• Restricting alcohol
• Avoiding grapefruit and grapefruit juice due to their effect on a group of
immunosuppressive medications (calcineurin inhibitors)
• After your bone marrow transplant, regular physical activity helps you control
your weight, strengthen your bones, increase your endurance, strengthen your
muscles and keep your heart healthy. As you recover, you can slowly increase
your physical activity.
• Taking steps to prevent cancer is even more important after your transplant.
Don't smoke.