Blood Disorders

Blood Diseases: White and Red Blood Cells, Platelets and Plasma

A blood cell disorder is a condition in which there’s a problem with your red blood cells, white blood cells, or the smaller circulating cells called platelets, which are critical for clot formation. All three cell types form in the bone marrow, which is the soft tissue inside your bones. Red blood cells transport oxygen to your body’s organs and tissues. White blood cells help your body fight infections. Platelets help your blood to clot. Blood cell disorders impair the formation and function of one or more of these types of blood cells.

Symptoms of blood cell disorders

Symptoms will vary depending on the type of blood cell disorder. Common symptoms of red blood cell disorders are:

fatigue

shortness of breath

trouble concentrating from lack of oxygenated blood in the brain

muscle weakness

a fast heartbeat

Common symptoms of white blood cell disorders are:

chronic infections

fatigue

unexplained weight loss

malaise, or a general feeling of being unwell

Common symptoms of platelet disorders are:

cuts or sores that don’t heal or are slow to heal

blood that doesn’t clot after an injury or cut

skin that bruises easily

unexplained nosebleeds or bleeding from the gums

Red blood cell disorders

Anemia

Iron deficiency anemia: Iron deficiency anemia occurs when your body does not have enough iron. You may feel tired and short of breath because your RBCs are not carrying enough oxygen to your lungs. Iron supplementation usually cures this type of anemia.

Pernicious anemia: Pernicious anemia is an autoimmune condition in which your body is unable to absorb sufficient amounts of vitamin B-12. This results in a low number of RBCs. It is called “pernicious,” meaning dangerous, because it used to be untreatable and often fatal. Now, B-12 injections usually cure this type of anemia.

Aplastic anemia: Aplastic anemia is a rare but serious condition in which your bone marrow stops making enough new blood cells. It can occur suddenly or slowly, and at any age. It can leave you feeling tired and unable to fight off infections or uncontrolled bleeding.

Autoimmune hemolytic anemia (AHA): Autoimmune hemolytic anemia (AHA) causes your immune system to destroy your red blood cells faster than your body can replace them. This results in you having too few RBCs.

Sickle cell anemia: Sickle cell anemia (SCA) is a type of anemia that draws its name from the unusual sickle shape of the affected red blood cells. Due to a genetic mutation, the red blood cells of people with sickle cell anemia contain abnormal hemoglobin molecules, which leave them rigid and curved. The sickle-shaped red blood cells can’t carry as much oxygen to your tissues as normal red blood cells can. They may also become stuck in your blood vessels, blocking blood flow to your organs.

Thalassemia

Thalassemia is a group of inherited blood disorders. These disorders are caused by genetic mutations that prevent the normal production of hemoglobin. When red blood cells do not have enough hemoglobin, oxygen doesn’t get to all parts of the body. Organs then do not function properly. These disorders can result in:

bone deformities

enlarged spleen

heart problems

growth and developmental delays in children

Polycythemia vera

Polycythemia is a blood cancer caused by a gene mutation. If you have polycythemia, your bone marrow makes too many red blood cells. This causes your blood to thicken and flow more slowly, putting you at risk for blood clots that can cause heart attacks or strokes. There is no known cure. Treatment involves phlebotomy, or removing blood from your veins, and medication.

White blood cell disorders

White blood cells (leukocytes) help defend the body against infection and foreign substances. White blood cell disorders can affect your body’s immune response and your body’s ability to fight off infection. These disorders can affect both adults and children.

Lymphoma

Lymphoma is a blood cancer that occurs in the body’s lymphatic system. Your white blood cells change and grow out of control. Hodgkin’s lymphoma and non-Hodgkin’s lymphoma are the two major types of lymphoma.

Leukemia

Leukemia is blood cancer in which malignant white blood cells multiply inside your body’s bone marrow. Leukemia may be either acute or chronic. Chronic leukemia advances more slowly.

Myelodysplastic syndrome (MDS)

Myelodysplastic syndrome (MDS) is a condition affecting the white blood cells in your bone marrow. The body produces too many immature cells, called blasts. The blasts multiply and crowd out the mature and healthy cells. Myelodysplastic syndrome may progress either slowly or quite fast. It sometimes leads to leukemia.

Platelet disorders

Blood platelets are the first responders when you have a cut or other injury. They gather at the site of the injury, creating a temporary plug to stop blood loss. If you have a platelet disorder, your blood has one of three abnormalities:

Not enough platelets. Having too few platelets is quite dangerous because even a small injury can cause serious blood loss.

Too many platelets. If you have too many platelets in your blood, blood clots can form and block a major artery, causing a stroke or heart attack.

Platelets that don’t clot correctly. Sometimes, deformed platelets can’t stick to other blood cells or the walls of your blood vessels, and so can’t clot properly. This can also lead to a dangerous loss of blood.

Platelet disorders are primarily genetic, meaning they are inherited. Some of these disorders include:

Von Willebrand disease

Von Willebrand disease is the most common inheritedbleeding disorder. It is caused by a deficiency of a protein that helps your blood clot, called von Willebrand factor (VWF).

Hemophilia

Hemophilia is probably the best-known blood clotting disorder. It occurs almost always in males. The most serious complication of hemophilia is excessive and prolonged bleeding. This bleeding can be either inside or outside your body. The bleeding can start for no apparent reason. Treatment involves a hormone called desmopressin for mild type A, which can promote release of more of the reduced clotting factor, and infusions of blood or plasma for types B and C.

Primary thrombocythemia

Primary thrombocythemia is a rare disorder that can lead to increased blood clotting. This puts you at higher risk for stroke or heart attack. The disorder occurs when your bone marrow produces too many platelets.

Acquired platelet function disorders

Certain drugs and medical conditions can also affect the functioning of platelets. Be sure to coordinate all your medications with your doctor, even over-the-counter ones you choose yourself. The Canadian Hemophilia Association (CHA) warns that the following common drugs may affect platelets, especially if taken long-term.

aspirin

nonsteroidal anti-inflammatory (NSAIDs)

some antibiotics

heart drugs

blood thinners

antidepressants

anesthetics

antihistamines

Plasma cell disorders

There are a large variety of disorders that affect the plasma cells, the type of white blood cells in your body that make antibodies. These cells are very important to your body’s ability to ward off infection and disease.

Plasma cell myeloma

Plasma cell myeloma is a rare blood cancer that develops in the plasma cells in the bone marrow. Malignant plasma cells accumulate in the bone marrow and form tumors called plasmacytomas, generally in bones such as the spine, hips, or ribs. The abnormal plasma cells produce abnormal antibodies called monoclonal (M) proteins. These proteins build up in the bone marrow, crowding out the healthy proteins. This can lead to thickened blood and kidney damage. The cause of plasma cell myeloma is unknown.

Diagnosis

Your doctor may order several tests, including a complete blood count (CBC) to see how many of each type of blood cell you have. Your doctor may also order a bone marrow biopsy to see if there are any abnormal cells developing in your marrow. This will involve removing a small amount of bone marrow for testing.

Treatment Options

Your treatment plan depends on the cause of your illness, your age, and your overall health status.

Medication

Some pharmacotherapy options include medications such as Nplate (romiplostim) to stimulate the bone marrow to produce more platelets in a platelet disorder. For white blood cell disorders, antibiotics can help fight infections. Dietary supplements such as iron and vitamin B-9 or B-12 can treat anemia due to deficiencies. Vitamin B-9 is also called folate, and vitamin B-12 is also known as cobalamin.

Surgery

Bone marrow transplants may repair or replace damaged marrow. These involve transferring stem cells, usually from a donor, to your body to help your bone marrow begin producing normal blood cells. A blood transfusion is another option to help you replace lost or damaged blood cells. During a blood transfusion, you receive an infusion of healthy blood from a donor.

Both procedures require specific criteria to succeed. Bone marrow donors must match or be as close as possible to your genetic profile. Blood transfusions require a donor with a compatible blood type.