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 - 2024/10/10 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1182909549 ER -