Our body’s crimson tide: understanding blood disorders and the vital role of blood donation

From ancient observations to cutting-edge gene editing, the field of haematology -the study of blood is undergoing a profound transformation, offering new hope and more precise interventions for an array of conditions, both benign and malignant.

Our blood is a complex mixture of four key components working in harmony. The liquid base is plasma, a yellowish fluid that transports nutrients, hormones, and clotting proteins throughout the body. Floating within it are RBCs – red blood cells, the oxygen carriers, responsible for energising every cell. Our silent defenders, the WBCs – white blood cells, form the core of our immune system, fighting off infections. Finally, tiny platelets act as first responders, rushing to the site of an injury to form clots, working hand in hand with clotting proteins to stop bleeding. Together, this intricate team ensures our bodies function and thrive.

Deep within our larger bones lies the bone marrow, the remarkable factory responsible for producing our entire blood supply. This spongy tissue is a powerhouse of stem cells, which undergo a miraculous process called hematopoiesis. These master stem cells transform to form the different components of blood such as WBCs, RBCs and platelets. This continuous production is vital, as blood cells have a limited lifespan and need constant replenishment. Essentially, the health of our very bones dictates the vitality of the river of life flowing through our veins, highlighting bone marrow’s unsung role in our daily survival.

An introduction to haematology

Haematology is the study of conditions affecting our blood cells and blood-forming organs. These are broadly categorised into benign and malignant diseases. Benign haematological conditions, though non-cancerous, can severely impact life. Examples include anaemias (like iron deficiency), bleeding disorders such as haemophilia, clotting disorders (thrombophilias), and inherited conditions like sickle cell disease and thalassaemia, which affect haemoglobin production.

Malignant haematological diseases, or blood cancers, arise from the uncontrolled production of abnormal blood cells. The three main groups are leukemias (cancers of blood-forming tissue in bone marrow), lymphomas (cancers of the lymphatic system), and myelomas (cancer of plasma cells). Understanding this spectrum highlights the diverse challenges haematology tackles, from chronic inherited illnesses to aggressive cancers.

Blood — body’s barometer and window to diagnosis

Blood acts as a dynamic window into the body’s health, making blood tests invaluable diagnostic tools. A Complete Blood Count (CBC) provides quantitative data on red cells, white cells, and platelets, indicating infections, anaemias, or potential malignancies. Microscopic examination of a peripheral blood smear is one of the important investigations which can reveal abnormal cell morphology characteristic of specific diseases; assessment of functions of vital organs such as the liver and kidneys are done by liver function tests and kidney function tests. For deeper insights, a bone marrow aspiration and biopsy allow direct examination of the blood cell “factory.”

Advances in the study of chromosomes such as karyotyping and FISH (Flourescent in situ hybridization)have been aiding us in risk stratification of leukemias. Recent molecular advancements like NGS (Next-Generation Sequencing) and PCR (polymerase chain reaction) have revolutionised haematological diagnostics. NGS enables rapid sequencing of DNA and RNA, identifying specific genetic mutations and abnormalities that define subtypes of blood cancers. This molecular fingerprinting aids in precise diagnosis, risk stratification, prognosis, treatment selection, and monitoring for disease relapse.

Liquid Biopsy, the analysis of tumour-derived material like circulating tumour DNA (ctDNA) in the blood, offers a minimally-invasive way to detect cancer, monitor treatment response, and identify resistance mutations without repeated invasive biopsies. These advanced diagnostics are propelling haematology towards personalised medicine, tailoring interventions based on the molecular characteristics of a patient’s disease.

Give blood, give hope

Patients with benign diseases such as thalassemia, sickle cell anaemia and patients undergoing chemotherapy often have high transfusion requirements of both blood and platelets.

ThisWorld Blood Donor Day, June 14, as the world rallies under the theme, ‘Give blood, give hope: together we save lives,’ let us recognise the profound impact of a simple, yet powerful act: blood donation. In a world facing constant health challenges, the need for safe blood is a universal constant, and every drop counts.