TY  - CHAP
M1  - Book, Section
TI  - Approach to Suspected Hematologic Disorders
A1  - Shapiro, Mary C.
A1  - Yates, Amber M.
A2  - Kline, Mark W.
PY  - 2018
T2  - Rudolph's Pediatrics, 23e
AB  - Diseases  of  the  blood  involving  infants,  children,  and  adolescents  are  commonly  encountered  by  primary  care  providers.  Many  hematologic  problems  are  straightforward  and  easy  to  diagnose  and  manage  without  involvement  of  a  subspecialty  consultant.  However,  others  may  be  rare,  serious,  or  even  life-threatening;  these  represent  complex  diagnostic  and  management  challenges.  In  such  cases,  engagement  of  a  pediatric  hematology-oncology  subspecialist  is  recommended.  The  American  Board  of  Pediatrics  has  certified  more  than  2000  practitioners  in  this  subspecialty.  For  good  reason,  hematology  and  oncology  have  been  combined  as  a  single  subspecialty  discipline  for  several  decades.  One  of  the  first  recognizable  conditions  treated  by  children’s  blood  specialists  was  acute  leukemia.  As  the  principles  of  combination  chemotherapy  became  clear  during  the  1960s,  the  drugs  used  to  treat  leukemia  were  also  found  to  be  effective  in  treating  solid  tumor  malignancies.  Hematology-oncology  thus  became  a  combined  specialty  by  the  1970s  and  has  remained  so  from  the  standpoint  of  board  certification.  Nevertheless,  the  increasing  complexity  of  the  field  during  the  past  few  decades  has  resulted  in  some  practitioners  focusing  primarily  in  one  clinical  area  or  the  other  (oncology  versus  hematology),  especially  those  working  in  large  metropolitan  areas  where  patient  numbers  justify  this  sub-subspecialization.  Hematology-oncology  specialists  tend  to  be  concentrated  in  academic  medical  centers  where  they  conduct  clinical  or  laboratory  research  as  well  as  teach  and  provide  patient  care.  For  years,  the  standard  of  care  in  childhood  cancer  has  included  these  patients’  enrollment,  if  possible,  in  peer-reviewed  multicenter  research  studies.  More  recent  advances  have  also  fostered  clinical  trial  participation  becoming  accepted  practice  in  children  with  nonmalignant  hematologic  conditions,  such  as  sickle  cell  disease  and  hemophilia.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1182909549
ER  -