Anaemia and abnormal blood counts 

Patients are referred to general haematology by GPs and hospital doctors.

Patients are most commonly referred after having abnormal blood tests that suggest there might be a blood or bone marrow disorder or following an abnormal blood count (a test to check the types and numbers of cells in your blood, including red blood cells, white blood cells and platelets).

What is anaemia?

Anaemia is a condition in which the body has fewer red blood cells, or have less haemoglobin in the red blood cells, than normal. Red blood cells carry oxygen to tissues and organs throughout the body and enable them to use energy from food. With anaemia, red blood cells carry less oxygen to tissues and organs (particularly the heart and brain) and those tissues and organs may not function as well as they should.

  • Iron deficiency anaemia

    Iron deficiency anaemia is a condition where a lack of iron in the body leads to a reduction in the number of red blood cells.

  • Anaemia of chronic disease

    Anaemia of chronic disease (ACD), sometimes known as anaemia of inflammation, is the second most common form of anaemia worldwide and is seen in a variety of conditions, including cancer, autoimmune conditions and infections.

  • Anaemia related to renal disease

    When kidneys are diseased or damaged, they do not produce enough of a hormone called erythropoietin (EPO). EPO tells the bone marrow to make red cells. As a result, the lack of EPO causes the bone marrow to make fewer red blood cells, causing anaemia. When blood has fewer red blood cells, it deprives the body of the oxygen it needs.

  • Pre-operative anaemia

    Pre-operative anaemia can significantly affect how successful surgery is for a patient. Anaemia is an independently predictive risk factor for surgery related complications and death.

    If you are having a surgical operation at UCLH you may be sent to the general haematology clinic to be tested for anaemia. This will allow the team to perform investigations that aim to identify the cause of the anaemia and potentially correct it before your operation.

Abnormal blood counts (platelets and white cell count)

In addition to anaemia you may be found to have another abnormality in your blood count. This is found using a blood test called a full blood count (FBC). This is a test to check the types and numbers of cells in your blood, including red blood cells, white blood cells and platelets.

This can help give an indication of your general health, as well as provide important clues about certain health problems you may have. You may be found to have an abnormal blood count. This may be any of the following:

  • Too many red cells (polycythaemia)

    If you have this condition you will be seen on the Red Cell Unit. Patients with a specific type of polycythaemia (polycythaemia vera) will be seen in the myeloproliferative disorders (MPD) clinic.

  • Too few white blood cells (leukopenia)

    Depending on which type of white cell is reduced it can be called neutropenia, lymphopenia or eosinopenia.It can be due to many causes that can be both benign (non-cancerous) and malignant (cancerous).

  • Too many white blood cells (leucocytosis)

    Depending on which type of white cell is increased it is called neutrophilia, lymphocytosis, eosinophilia, monocytosis or basophilia.

  • Too few platelets (thrombocytopenia)

    This may make you bruise or bleed easily. There are various causes.

  • Too many platelets (thrombocythaemia or thrombocytosis)

    This is due to disorders which affect cells in the bone marrow which make platelets. It can potentially increase the risk of cardio or cerebrovascular disease and blood clots.

Many people referred to these clinics worry that they have cancer. This will be true for some people, but most of patients referred to the general clinic do not have cancer.

Often additional investigations are required to help to make a diagnosis. These may include additional blood tests, x-rays, scans and a bone marrow biopsy. Once the results of the investigations are obtained, many patients will be discharged from the haematology clinics. However, some will need further investigation and treatment in a different clinic specific for the type of illness that has been diagnosed.

 Consultants

Dr Perla Eleftheriou, Consultant Haematologist

Dr Perla Eleftheriou

Dr Perla Eleftheriou is clinical governance lead of the Red Cell Haematology department at UCH. Her area of special interest is Red Cell Disorders, which include haemoglobinopathies and rare anaemias, as well as polycythaemias and iron overload disorders. Dr Eleftheriou teaches haematology at the London School of Hygiene and Tropical Medicine and is a visiting lecturer of haematology at the Nicosia Medical School in Cyprus. Dr Eleftheriou also serves as clinical/scientific adviser to Thalassaemia International Federation and is a member of the UK Thalassaemia Society.

Full consultant profile

Dr Sajir Mohamedbhai, Honorary Consultant Haematologist

Dr Sajir Mohamedbhai

Sajir Mohamedbhai is an honorary consultant haematologist. He is a member of the lymphoma team at UCLH and runs a general haematology clinic. He is involved in recruiting patients into clinical trials in lymphoma.

“I enjoy being part of a highly dedicated and friendly team, where everyone is committed to going the extra mile for our patients. It is particularly rewarding to see the positive impact this has on our patients' lives”

Full consultant profile

Dr Wai Keong Wong, Consultant Haematologist

Dr Wai Keong Wong is a Consultant Haematologist specialising in Bone Marrow Diagnostics and clinical IT and informatics. He lists his specialist area of research as the application of Informatics and IT to drive quality improvement.

"The most rewarding part of UCLH is working in a constantly changing and dynamic environment within an organisation with true vision and ambition. It also helps that everyone is very nice and friendly."