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Research That Revolutionized Patient Care

The explosive progress in the field of molecular biology has yielded fundamental insights into the origin of human diseases and sparked the development of treatments that have transformed medicine. Nowhere are these changes more prominent than in the field of hematology, which serves as a paradigm for the movement of knowledge from the bench to the bedside. The past 50 years have seen major clinical advances that arose from cutting-edge basic research, including, for example, the development of recombinant growth factors that stimulate blood cell production, blood-forming stem cell transplant techniques, safer and more effective products for transfusion, the discovery of water channels…

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 Classical Hematology: A Specialty in Decline?

Some specialists are also pushing for a separation of hematology and oncology fellowship training because of the complexities of both fields. “We are in a historical moment,” Dr. Brodsky said. “When I was in training, there were eight to 10 chemotherapy drugs. For anticoagulation, there was aspirin, heparin, and warfarin.” Now, there are more than 15 anticoagulants, and numerous antiplatelet agents, with more coming. And, “as far as cancer therapeutics go, forget it!” Dr. Brodsky said. “It is very hard to stay current in both fields,” he acknowledged. “With hematology and oncology, you can’t be good at both.” Dr. Lyons believes that refocusing efforts on growing the number of hematology-specific training programs could benefit the field, but he was hesitant to endorse the idea of eliminating combined fellowship programs.

Articles of Interest

AI in hematology: ‘The good, the bad and the ugly’

As AI’s role expands, some patients fear the possibility of losing face-to-face interaction with their health care providers. This concern may be justified given an already dwindling sense of in-person communication.

Classical Hematology

ASH has adopted the term “classical hematology” in place of “non-malignant” or “benign” to refer to a broad range of non-cancerous blood disorders. Use of the terms “benign” and “non-malignant” has done both practitioners and patients a disservice by minimizing the seriousness of what are often life-threatening blood conditions. The term “classical hematology” helps us define the field by what it is rather than what it is not, while celebrating centuries of scientific advances and progress fundamental to every aspect of health care and medicine.  

Classical Hematology: Better Name, Same Great Field

For many hematologists, the term “benign hematology” has never felt quite right. Considering the actual definition of the word “benign” (“of a mild type or character that does not threaten health or life; having no significant effect; harmless”), many of us often remark that there is nothing benign about “benign” hematology.

Classical Hits: A Hematology Review

Classical hematology, or the study of nonmalignant, but not so “benign,” hematologic conditions evokes an image of white bearded, Latin speaking, tweed blazer (with elbow patches) wearing physicians, gathering in dusty, musty libraries. But based on all the exciting sessions at the 2020 ASH Annual Meeting, it is clear that classical hematology is anything but stodgy. Over the past three decades, the care of patients with hemophilia has evolved from sole reliance on plasma derived therapies to the development of non-factor products and the promise of gene therapy. Though plasma derived therapies held great promise, they also carried enormous consequences. And no one knows this better than author and activist Dr. Robert Massie, who was born with severe hemophilia and acquired HIV and hepatitis...

Hematology: the specialty with a record number of new approvals

Hematology flows from the Greek haimo-, or “blood,” and the Latin logia, or “the study of.” Since blood has been an easy target to study, several eminent figures, also called “fathers” and “mothers” of hematology, have significantly contributed to the success story of this specialty. Over the last 30 years, hematologists have witnessed miracles in multiple fields, such as transplantation that evolved from fresh blood to peripheral stem cells and now cellular or gene therapies; or chronic myeloid leukemia that has been one of the first curable cancer without chemotherapy. Tremendous research and development in this unique clinico-laboratory specialty has led to better understanding of multiple disorders and targeted therapies.

Please Don’t Call Me a Classical Hematologist

I am a hematologist who cares for patients with bleeding or clotting problems, disorders of iron metabolism, or abnormal blood cell counts. I direct basic and clinical research projects in hemophilia, thrombosis, anemia, and thrombocytopenia. I consider the American Society of Hematology (ASH) to be my professional home. Therefore, I was distressed to learn that the ASH Executive Committee has endorsed the term “classical hematology” to refer to my subspecialty.1 Despite practicing as an academic hematologist for more than 30 years, I was not familiar with the term “classical hematology.” So, I did what my students are now often doing: I asked ChatGPT. I received the following response to the query “What is classical hematology?”:

The Future of Hematology: Many Advances, More Specialists

The field of hematology has a bright outlook—but not without its shadows. Advances in the treatment of blood cancers, solid tumors, and blood disorders have accelerated in the last 30 years, changing the game for people with cancer and giving hope to those living with chronic blood diseases. At the same time, there is a concerning decline in the number of hematology practitioners, both subspecialists and generalists. The population of practicing hematologists and oncologists is rapidly aging, and not enough early-career hematologists are joining the field to replace soon-to-be retiring physicians.

The Future of Hematology: The Growing Demand for Subspecialists and Ideas to Increase Interest in the Field Among Medical Residents

Seeing patients with cancer living meaningful lives is a significant motivator for residents to specialize in this arena. It is imperative that programs start offering both outpatient and inpatient experiences in hematology/oncology, with residents seeing patients in clinic under the guidance of a preceptor. A study should subsequently be done comparing resident experiences before and after an outpatient experience in hematology/oncology. For those residents who pursue an inpatient hematology/oncology experience, the goal should be to reduce distress, cultivate empathy, and help them find meaning in caring for patients who are near death.

Under-representation of classical hematology training on hematology-oncology fellowship program websites in the United States

Medical trainees have long relied on websites to gather general information about training programs. In this study of ACGME-accredited adult hematology-oncology fellowship training program websites in the United States, we found that only 33% of programs specifically advertised classical hematology training, despite ACGME and American Board of Internal Medicine guidelines that require combined programs to dedicate at least one-third of their curriculum to classical hematology.

What it’s like to specialize in hematology: Shadowing Dr. Lee

Hematology is a very interesting and complex field that crosses all disciplines. A lot of patients come to see a hematologist either because they have an unusual constellation of symptoms without a diagnosis and are seeking answers, or because they have a rare disease that is unfamiliar to other providers.

Resources

American Society of Hematology

The American Society of Hematology (ASH) is the world’s largest professional society of clinicians and scientists who are dedicated to conquering blood diseases. Since 1958, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology.