Platelet and White Blood Cell Disorders

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Platelet and White Blood Cell Disorders
Health conditions that create abnormally high or low platelet or other blood cell numbers may cause specific symptoms, depending on the type of cell involved and the underlying cause. However, some of these conditions may not cause any symptoms and are discovered during a patient’s routine blood testing. Regardless of cell type involved and symptoms, it is generally recommended that patients who have abnormal blood cell counts be evaluated to discover the cause so they can receive appropriate therapy if needed.

Many health conditions can cause an abnormally low or high number of cells found in the blood (red blood cells, white blood cells or platelets).

Low blood cell counts: Disorders with low numbers of blood cells can be due to increased destruction of cells after they are produced, or decreased production of cells by bone marrow. Increased blood cell destruction can be caused by immune mechanisms — such as autoimmunity or drug-induced immunity — in which the body produces antibodies that attack blood cells. It can also occur when blood cells are consumed during severe infections or uncontrolled clotting, for example.

High blood counts: Abnormally high blood cell numbers can occur when the body reacts to unusual stress, such as chronic infection which produces high numbers of platelets. Unusually high blood cell numbers can also occur when normal regulatory mechanisms for blood cell production and destruction are damaged — for example, the high numbers of white blood cells that occur with chronic leukemia.

Red blood cell disorders: Conditions involving low numbers of red blood cells (RBCs) include anemia due to nutritional deficiencies (iron, vitamin B12 or folate), increased red cell destruction due to autoantibodies (hemolytic anemia), and anemia of inflammation or chronic disease (as seen in kidney failure), among other disorders with low RBC levels. The Benign Hematology Clinic also assists in diagnoses and treatment recommendations for patients with abnormally high levels of RBCs (polycythemia).

White blood cell disorders: Low white blood cell (WBC) counts occur in conditions such as autoimmune neutropenia, drug-induced neutropenia or myelodysplasia. High WBC counts often occur in conditions such as chronic inflammation or myeloproliferative disorders.

Platelet disorders: Low numbers of platelets can be evident in disorders like immune thrombocytopenia (ITP). Conditions associated with high platelet counts can include reactive thrombocytosis or essential thrombocythemia. 

These health conditions may cause specific symptoms, depending on the type of cell involved and the underlying cause. However, some of these conditions may not cause any symptoms and are discovered during routine blood testing. Regardless of cell type and presence or absence of symptoms, it is generally recommended that patients who have abnormal blood cell counts be evaluated to discover the cause so they can receive appropriate therapy if needed.

Platelet and White Blood Cell Service Approach
BloodCenter of Wisconsin, in collaboration with Froedtert & The Medical College of Wisconsin, staffs the Benign Hematology Clinic located on the Froedtert/Medical College campus. There, our team of physicians and clinical staff evaluates patients with platelet and blood cell disorders who have been referred to the clinic. Together, our experts conduct research and help referring physicians make accurate diagnoses and manage the treatment of these patients. Our physicians and staff work closely with referring physicians to help them diagnose and manage treatment for patients with bleeding and clotting disorders, and conditions causing abnormal blood counts. 

Evaluations at the Benign Hematology Clinic begin with referral facilitators who talk with patients to assess their needs. Our clinical coordinator provides further assistance, and our nurse practitioner collaborates with our physicians to provide patients with the best possible care. Evaluations are performed by Medical Science Institute physicians who are ABIM board-certified hematologists with access to a full array of laboratory testing.

Evaluations available at the Benign Hematology Clinic
Testing is provided by the Diagnostic Reference Laboratories of BloodCenter of Wisconsin and a tertiary medical center laboratory (Dynacare). BloodCenter’s Diagnostic Labs provide specialized testing for the evaluation of disorders involving abnormal numbers of blood cells including immune and non-immune disorders of red blood cells, white blood cells and platelets. Evaluations available at the clinic include:
  • Pancytopenia
  • Leukopenia
  • Thrombocytopenia
  • (Auto) Immune thrombocytopenia (ITP)
  • Drug-induced cytopenias (anemia, thrombocytopenia, leukopenia)
  • Anemia, including iron deficiency, other nutritional anemias, and autoimmune hemolytic anemia
  • Leukocytosis
  • Thrombocytosis (reactive and essential thrombocythemia)
  • Polycythemia (suspected primary – PV,  and secondary)
  • Myelodysplasia
  • Myeloproliferative disorders (myelofibrosis, polycythemia vera, essential thrombocythemia)
  • Hematology in pregnancy: gestational thrombocytopenia, ITP
  • Monoclonal gammopathy of undetermined significance (MGUS)

Research
Experts at BloodCenter of Wisconsin and Froedtert & The Medical College of Wisconsin collaborate in a variety of clinical research, specialized testing and clinical trials to help improve diagnoses and care for patients who have platelet and blood cell disorders.

Translational Science:
  • Serologic testing for Heparin induced thrombocytopenia
  • Diagnosis and management of alloimmune platelet disorders (neonatal alloimmune thrombocytopenia and post transfusion purpura)
  • Diagnosis of Transfusion Induced Acute Lung Injury (TRALI)
  • Diagnosis of Drug induced thrombocytopenia, neutropenia and hemolytic anemia

Clinical Trials
  • Wisconsin Core Clinical Center for Transfusion Medicine and Hemostasis Clinical Trials Network (TMH-CTN)

    - High dose granulocyte transfusions for the treatment of infection (Resolving Infection in Neutropenia with Granulocytes (RING)) – a randomized controlled trial of optimal antibiotic therapy with high dose granulocyte transfusions vs. optimal antibiotic therapy alone in neutropenic patients with serious bacterial or fungal infections

    - Red cell storage duration study (RECESS) – a randomized controlled trial of RBC transfusions using blood stored < 10 days vs. > 21 days in patients   undergoing complex (likely to require blood transfusion) open heart surgeries

Information for Professionals
Physicians and staff at the Froedtert & The Medical College of Wisconsin Benign Hematology Clinic work closely with referring physicians to coordinate treatment and follow-up care. Our team provides an initial evaluation report after the patient’s first visit and subsequent progress reports. Consultations are readily available.

To refer your patient or receive more information about the Benign Hematology Clinic, call 414-805-0505 or 866-680-0505. For physician-to-physician consultation, please call 414-805-4700 or 877-804-4700.

The Benign Hematology team sees patients at the Froedtert & The Medical College of Wisconsin Clinical Cancer Center in the multidisciplinary clinics: life quadrant, second floor. NOTE: Please notify your patients that while our clinic is located within the Clinical Cancer Center, that does not mean they have a cancer diagnosis.