Blood Clotting & Bleeding Disorders

Blood clotting and bleeding disorders treated by the physicians at the Center for Hematologic Malignancies include:

• Immune thrombocytopenic purpura
• Hypercoagulable disorders
• Hemophilia and other bleeding disorders

Immune thrombocytopenic purpura

Immune thrombocytopenic purpura is a condition that affects the blood's ability to clot. This is because the number of platelets (thrombocytes) in the blood is low. Platelets play an important role in helping blood to clot and stop bleeding.

There are two kinds of immune thrombocytopenic purpura:

1. Acute immune thrombocytopenic purpura, which usually occurs in children after a virus, and generally goes away on its own after about six months
2. Chronic immune thrombocytopenic purpura, which usually occurs in adults, and lasts more than six months

Immune thrombocytopenic purpura is also called idiopathic thrombocytopenic purpura.

Symptoms

The common symptoms of ITP include:

• Bruising
• Cuts not clotting after an extended period of time
• Nosebleeds
• Bloody gums
• Bloody urine or bowel movements
• Tiny, flat blood spots under the skin called petechiae

Diagnosis
When a patient presents with symptoms that may suggest immune thrombocytopenic purpura, your doctor will use several diagnostic methods to make an accurate diagnosis.

1. Your doctor will ask for a complete medical history and will perform a thorough physical examination. Diagnostic tests may include:

• Blood Tests
• Biopsies. During a biopsy, a small sample of bone marrow and/or bone is taken from the hip or another large bone so doctors can look at its make-up in order to find any signs of abnormal changes.

  There are two common types of biopsy used to help diagnose blood cancers and diseases:

  • Bone marrow aspiration--the sample of bone marrow is taken by putting a thin needle into the bone and removing a sample of the marrow
  • Bone marrow biopsy--a sample of both the bone and bone marrow is taken from the bone with a thick needle

  Once a bone marrow sample is obtained, it can be analyzed in a laboratory by a pathologist to determine what type of blood cancer or disease is present.

  2. Your doctor may want to do further tests. These tests may include radiographic evaluations.

  ITP is diagnosed by ruling out all other causes of low platelets.

Treatment

Treatment of ITP depends on the number and severity of symptoms.

In some cases, no treatment may be necessary beyond careful monitoring of platelet levels in the blood. In other cases, medication may be necessary. In rare cases, it may be necessary to remove the spleen, the organ in the body whose job is to clean blood.

Treatment will vary from patient to patient. The team of specialists at the Center for Hematologic Malignancies is highly experienced at working with patients to develop effective individualized treatment plans, using our comprehensive approach for blood malignancies.

Learn more about treatment.

Hypercoagulable disorders

A hypercoagulable disorder is a condition that increases the risk of having the blood clot. In a healthy body, when a blood vessel is damaged, it begins to leak blood. A cell called a platelet forms a loose plug at the site of the leak to stop the bleeding. Coagulation factors form at the site of the platelet plug to make it strong enough to stop bleeding until the leak is healed.

Once the healing is complete, the body breaks down the clot and takes it away. In patients with hypercoagulable disorders, there is a problem in the system that forms the plugs. Because of this plugs can form when they are not needed and can block healthy blood vessels.

Symptoms

Symptoms of hypercoagulable disorders include:

• Deep vein thrombosis (blood clots in the veins of the lower leg)
  • Pain where clot has occurred
  • Swelling where clot has occurred
• Heart attack or stroke
• Shortness of breath
• Chest pain
• Blood clots in unusual places

Diagnosis
When a patient presents with symptoms that may suggest a hypercoagulable disorder, your doctor will use several diagnostic methods to make an accurate diagnosis.

1. Your doctor will ask for a complete medical history and will perform a thorough physical examination. Diagnostic tests may include:

• Blood Tests
• Biopsies. During a biopsy, a small sample of bone marrow and/or bone is taken from the hip or another large bone so doctors can look at its make-up in order to find any signs of abnormal changes.

  There are two common types of biopsy used to help diagnose blood cancers and diseases:

  • Bone marrow aspiration--the sample of bone marrow is taken by putting a thin needle into the bone and removing a sample of the marrow
  • Bone marrow biopsy--a sample of both the bone and bone marrow is taken from the bone with a thick needle

  Once a bone marrow sample is obtained, it can be analyzed in a laboratory by a pathologist to determine what type of blood cancer or disease is present.

  2. Your doctor may want to do further tests. These tests may include radiographic evaluations.

Treatment

Hypercoagulable disorders are usually treated with a course of anticoagulation medications. The combination of medications prescribed depends on the cause of the hypercoagulation, as well as other factors.

Treatment will vary from patient to patient. The team of specialists at the Center for Hematologic Malignancies is highly experienced at working with patients to develop effective individualized treatment plans, using our comprehensive approach for blood malignancies.

Hemophilia and other bleeding disorders

Hemophilia and other bleeding disorders are caused when the blood is not able to clot stop bleeding as quickly as it should. The body has several different clotting factors which help the blood make a plug to stop bleeding. There are many types of hemophilia, each caused when a specific clotting factor is not able to do its job.

If the amount of clotting factor that is affected is very low, spontaneous bleeding could occur. If the amount of clotting factor that is affected is low to medium, heavy bleeding could occur only after surgery or injury.

Symptoms

Common symptoms of hemophilia and other bleeding disorders include:

• Spontaneous bleeding
  • Lots of deep or big bruises
  • Unexplained bruising or bleeding
  • Unexplained nosebleeds
  • Blood in urine or bowel movements
  • Swelling and pain in joints (caused by internal bleeding)
  • Feeling tightness in joints
  • Bleeding for a long time from cuts, after surgery or having a tooth out
• Sudden swelling, pain and warmth in shoulders, elbows, hips or knees
• Sudden swelling, pain and warmth in arm and leg muscles
• Very painful headache that lasts a long time
• Double vision
• Vomiting
• Easily exhaustible
• Neck pain

Diagnosis

Hemophilia and other bleeding disorders are diagnosed by looking at the clotting factors present in a blood sample, taken in a blood test. Analyzing the sample can determine if a clotting factor is affected, and if so, which one.

Treatment

The treatment of hemophilia and other bleeding disorders depends on the type and severity of the hemophilia or bleeding disorder.

In some mild cases, a hormone injection can help the body make more the necessary clotting factors. In more serious cases, an infusion of clotting factor, usually from donated blood, is necessary to stop bleeding. Regular, preventative infusions of clotting factor may also be needed.

Treatment will vary from patient to patient. The team of specialists at the Center for Hematologic Malignancies is highly experienced at working with patients to develop effective individualized treatment plans, using our comprehensive approach for blood disorders.