Introduction

Pediatric hematology involves treatment of nonmalignant blood disorders as well as hematologic malignancies. This guide considers nonmalignant blood disorders. Hematologic malignancies are considered in the Pediatric Oncology rotation guide. The field of pediatric hematology has progressed considerably during the last few decades. Improvements have been made in the management of hematologic disorders, particularly sickle cell disease (SCD). The numerous improvements in the approach to SCD include dramatic decreases in infection-related mortality with the use of preventive antibiotics (generally, penicillin) and pneumococcal vaccinations, improved quality of life and life expectancy with hydroxyurea, and reduction in cerebral infarcts with chronic red-cell transfusions. For some patients, bone-marrow transplantation has even effected a cure.

Although much of the treatment for blood disorders occurs in the outpatient setting, patients are often admitted due to complications from their primary disease. In addition, hematologic complications may present both in otherwise healthy patients or in hospitalized patients with other underlying diseases.

This rotation guide is designed to help residents rotating through inpatient and outpatient hematology by providing an overview of common diagnoses encountered and suggested management. See the Pediatric Oncology rotation guide for an overview of common pediatric malignancies.

This rotation guide covers the following topics:

• Sickle Cell Disease

• Anemia

• Immune Thrombocytopenia

• Disorders of Hemostasis

• Transfusion Medicine