Management and Treatments with Hematopathology
The success of management/treatment of many illnesses can be judged by the results of interval blood tests. A good example is a blood count from a person being treated for anemia, which will demonstrate resolution of the red blood cell deficit with iron supplements.
- Viral load: A measurement of the number of viral particles in a milliliter of blood. In successful anti-HIV or hepatitis therapy, the viral load can be followed as it falls, indicating the therapy is effective.
- CD4: A type of white blood cell (T-cell), which is the immune cell damaged by HIV. A rise or a fall in the CD4 count can indicate improvement or worsening, respectively, of the disease’s effects on the body.
- White blood count: The number of white cells goes up with infection, and certain types of them will rise over the others when there are specific stimuli such as viral infection, bacterial infection, allergy, stomach conditions, etc. The certain types can be quantitated and placed in a list of counts for all of the different types, called a white blood cell count with differential.
- Immune system evaluation: Numbers of white cells can be tallied to give a picture of one’s immunological status, such as those receiving chemotherapy or radiation for cancer. This can tailor the dosing of these therapies accordingly.
- Clotting studies: Counting the number of platelets and testing to see how fast or effectively blood clots can identify a predisposition to thrombus formation, important in preventing embolic disease (clots that travel to block arteries) or in diagnosing bleeding disorders such as hemophilia. They are also useful in fine-tuning anticoagulation therapy used in clotting disorders.
- VDRL and other titers for syphilis: Although a positive VDRL only means one has had syphilis in the past, its titers (quantification) can be followed during therapy, falling as expected with successful treatment.
- Hormone levels: Thyroid function, hypofunction, or hyperfunction can be determined by thyroid stimulating hormone levels (TSH), and the fall in estrogen can be documented in therapies for endometriosis.
- Prenatal testing: Alpha-fetoprotein can give the risk of Down syndrome, as above. HCG, which rises in early pregnancy, is used as a pregnancy test, and its rising levels demonstrate that the pregnancy is progressing normally in the first trimester when there are signs of a threatened miscarriage; when not, a less-than-optimum rise can indicate a possible ectopic pregnancy.