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Health condition · Clinically reviewed

Blood disorders, from iron deficiency to leukaemia, myeloma and gene therapy.

A single-page map of the haematology landscape - anaemias, blood cancers, bleeding and clotting conditions - and how UK teams diagnose and treat them today.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against BSH, NICE, NHS England and peer-reviewed haematology sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK haematology practice including JAK inhibitors, CAR-T, bispecifics and MHRA-approved gene therapy for sickle cell and beta-thalassaemia.

Key facts

Blood disorders at a glance.

The essentials, in plain English - what haematology covers, the biggest categories, and where UK care sits today.

  • What it is

    A large family of conditions of the blood, bone marrow and clotting system, ranging from iron-deficiency anaemia to leukaemia, myeloma and inherited bleeding disorders.

  • Most common

    Iron-deficiency anaemia is by far the most common blood disorder in the UK, followed by B12 and folate deficiency and mild inherited bleeding disorders like von Willebrand disease.

  • Cancers

    Blood cancers include leukaemias (acute and chronic), lymphomas and myeloma. Together they account for a significant share of UK cancer diagnoses each year.

  • Inherited disorders

    Sickle cell disease, thalassaemias, haemophilia A and B, and von Willebrand disease are the main inherited haematology conditions seen in UK practice.

  • Foundation of care

    Full blood count, blood film, haematinics and coagulation studies are the starting point for nearly every haematology assessment.

  • Where it happens

    Care is shared between local GP, district general haematology and tertiary centres for transplant, CAR-T and gene therapy.

Why this guide matters

One map of a large specialty.

Haematology is broad. This page groups the disorders you are most likely to hear about, and points to detailed guides for the ones that need more depth.

  • Anaemias are common and treatable

    Iron, B12 and folate deficiency, haemolytic anaemias, sickle cell disease, thalassaemias and anaemia of chronic disease all have clear diagnostic and treatment pathways.

  • Blood cancers are highly specialist

    Leukaemias, lymphomas, myeloma and MDS are managed by dedicated MDTs with access to targeted therapy, CAR-T and transplant.

  • Clotting and bleeding matter

    From haemophilia to inherited thrombophilia, VTE and DIC - these disorders sit alongside anaemia and cancer as core haematology.

How the diagnosis is made

From first blood test to a precise haematology diagnosis.

The steps a UK GP or haematologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and examination

    Fatigue, bruising, bleeding, infections, weight loss, night sweats, family history and drug history all point the workup in a direction.

  2. 02

    Assessing

    Full blood count and film

    FBC with a manual blood film is the single most useful haematology test. Reticulocyte count, haematinics and LDH round out the picture.

  3. 03

    Assessing

    Coagulation and haemolysis screen

    PT, APTT, fibrinogen, LDH, haptoglobin, bilirubin and a direct antiglobulin (Coombs) test help separate bleeding, clotting and haemolytic disease.

  4. 04

    Confirming

    Bone marrow biopsy

    Aspirate and trephine with immunophenotyping, cytogenetics and FISH when a marrow disorder, leukaemia or myeloma is suspected.

  5. 05

    Confirming

    Molecular and genetic panels

    Haemoglobinopathy screen, thrombophilia panel, JAK2, CALR, MPL, BCR-ABL, FLT3 and IDH testing are matched to the suspected diagnosis.

  6. 06

    Planning

    Imaging and tissue biopsy

    CT, MRI and PET-CT stage lymphoma and myeloma. Lymph node or tissue biopsy confirms lymphoma subtype.

  7. 07

    Planning

    MDT and specialist referral

    Findings are discussed at a haematology MDT with links to transplant, CAR-T and gene therapy centres where needed.

Typical timeline: from an abnormal blood count to a full diagnosis in days to weeks, faster for suspected acute leukaemia.

Symptoms

What blood disorders can look like.

Symptoms are often vague. The combination of features and the FBC pattern is what points a haematologist toward the diagnosis.

  • Tiredness and breathlessness

    The classic presentation of anaemia, from iron deficiency to marrow failure. Worse on exertion, often gradual.

  • Easy bruising or bleeding

    Gum bleeding, heavy periods, nosebleeds and unexplained bruises can point to platelet, von Willebrand or clotting factor problems.

  • Repeated infections

    Frequent chest, urine or skin infections can reflect neutropenia, immune paresis in myeloma or CLL.

  • Lumps and lymph nodes

    Painless, persistent lymph node enlargement is a lymphoma red flag and warrants urgent review.

  • Night sweats and weight loss

    B symptoms in lymphoma and marrow disorders, alongside fever and pruritus.

  • Bone pain

    Back or rib pain in myeloma, sickle cell crises and marrow infiltration by leukaemia.

  • Thrombosis

    DVT, PE or unusual site clots can be the first sign of inherited thrombophilia, APS, PNH or an occult MPN.

  • Red flag - blasts on film

    Circulating blasts, pancytopenia or hyperleucocytosis need same-day haematology contact.

Treatment

How blood disorders are treated in the UK.

Treatments range from simple replacement to targeted molecules, immunotherapy, transplant and gene therapy - all delivered as part of a specialist plan.

  • Iron, B12 and folate

    Replacement therapy for nutritional anaemias. Oral or IV iron, intramuscular B12 and oral folate depending on cause and severity.

  • Transfusion support

    Red cells, platelets and plasma products, delivered under strict UK transfusion medicine standards with irradiated and CMV-safe products where indicated.

  • Hydroxycarbamide

    A workhorse in sickle cell disease, essential thrombocythaemia, polycythaemia vera and chronic myeloid disorders.

  • JAK inhibitors

    Ruxolitinib, fedratinib, momelotinib and pacritinib for myelofibrosis and polycythaemia vera resistant or intolerant to hydroxycarbamide.

  • Targeted therapy

    Venetoclax, ibrutinib, IDH and FLT3 inhibitors, azacitidine and decitabine for AML, CLL and MDS in appropriate patients.

  • Immunotherapy and antibodies

    Rituximab, obinutuzumab and other monoclonals for CLL and lymphoma, plus bispecific antibodies for relapsed disease.

  • CAR-T and stem cell transplant

    CAR-T for eligible relapsed lymphoma, ALL and myeloma. Allogeneic and autologous stem cell transplant for selected blood cancers and marrow failure.

  • Gene therapy

    MHRA-approved exagamglogene autotemcel (Casgevy) and lovotibeglogene autotemcel (Lyfgenia) for eligible patients with sickle cell disease and transfusion-dependent beta-thalassaemia.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or haematologist knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • British Society for Haematology (BSH). Guidelines across anaemia, MPN, MDS, leukaemia, lymphoma, myeloma and haemostasis.

  • NICE. Guidance and technology appraisals on haematological cancers, sickle cell disease, thalassaemia and gene therapies.

  • NHS England. Service specifications for haematology, stem cell transplant, CAR-T and specialist haemoglobinopathy centres.

  • MHRA. Approvals for exagamglogene autotemcel (Casgevy) and lovotibeglogene autotemcel (Lyfgenia) for sickle cell disease and beta-thalassaemia.

  • European Hematology Association (EHA). International guidelines on MPN, MDS, leukaemia, lymphoma and myeloma.

Red flags

When a blood disorder needs urgent care.

Most haematology conditions are managed in outpatients. These are the situations that need same-day assessment, not a routine appointment.

  • Neutropenic sepsis

    Fever in a patient on chemotherapy or with known neutropenia is a medical emergency. Same-day IV antibiotics under local sepsis pathways.

  • Tumour lysis syndrome

    Rapid cell breakdown in acute leukaemia or high-grade lymphoma. Requires hydration, allopurinol or rasburicase and close monitoring.

  • Hyperleucocytosis and leukostasis

    Very high white cell counts in acute leukaemia can cause pulmonary and neurological compromise. Needs urgent haematology input.

  • Acute promyelocytic leukaemia (APL)

    A haematology emergency. Treated with all-trans retinoic acid (ATRA) and arsenic trioxide, with high cure rates when recognised early.

  • Spinal cord compression in myeloma

    Back pain with limb weakness, bowel or bladder symptoms needs urgent MRI, high-dose steroid and specialist review.

  • Acute sickle cell chest crisis

    Chest pain, fever and hypoxia in sickle cell disease is life-threatening. Needs urgent hospital admission and exchange transfusion.

  • Major haemorrhage

    Massive bleeding in a patient on anticoagulation, with haemophilia, DIC or thrombocytopenia. Follow local major haemorrhage protocol.

  • Suspected TTP

    Thrombocytopenia, microangiopathic haemolysis and neurological or renal features. Needs same-day plasma exchange and specialist care.

  • New pancytopenia

    Unexplained low counts across all three cell lines can reflect aplastic anaemia, acute leukaemia or MDS and needs urgent haematology review.

Living with it

Long-term conditions, managed by a team.

Blood disorders often need lifelong follow-up. A clear plan, the right vaccines, good support and knowing your own red flags make the biggest difference.

A quiet reminder

You are part of the team.

Blood counts, symptom diaries and honest conversations with your specialist nurse and consultant shape the treatment plan more than any single test.

  1. 01 Care team

    Know your specialist centre

    For sickle cell, thalassaemia, haemophilia, transplant and CAR-T, care is often shared between a local team and a tertiary centre. Keep contact details to hand.

  2. 02 Vaccines

    Stay up to date with vaccination

    Pneumococcal, meningococcal, flu, COVID and Hib vaccination matter more if you have had splenectomy, transplant or ongoing immunosuppression.

  3. 03 Support

    Use the charities

    Anthony Nolan, DKMS, Blood Cancer UK, Sickle Cell Society, UK Thalassaemia Society, Aplastic Anaemia Trust, Haemophilia Society, Myeloma UK and Lymphoma Action all offer specialist support.

  4. 04 Escalate

    Learn your own red flags

    Fever on chemotherapy, sudden severe pain, breathlessness or unusual bleeding should trigger a call to your haematology team, not a wait-and-see.

Frequently asked

Everything we get asked about blood disorders.

Quick answers on blood tests, bone marrow biopsy, blood cancer treatments and gene therapy.

  • What counts as a blood disorder?

    Any condition primarily affecting the blood cells, bone marrow or clotting system. This includes anaemias, polycythaemias, leukaemias, lymphomas, myeloma, myelodysplastic syndromes, bleeding disorders like haemophilia and von Willebrand disease, and clotting disorders like inherited thrombophilia and antiphospholipid syndrome.

  • Which blood tests do haematologists usually start with?

    A full blood count with a blood film is the anchor. Reticulocyte count, haematinics (ferritin, B12, folate), LFTs, LDH, haptoglobin, bilirubin, a direct antiglobulin test and coagulation studies are added depending on the story. Haemoglobin electrophoresis or HPLC is used when a haemoglobinopathy is suspected.

  • When is a bone marrow biopsy needed?

    When the FBC and blood film point to a primary marrow problem such as leukaemia, MDS, myelofibrosis, aplastic anaemia or myeloma. Aspirate and trephine samples are sent for immunophenotyping, cytogenetics, FISH and molecular tests to make a precise diagnosis.

  • What has gene therapy changed for sickle cell and thalassaemia?

    The MHRA has approved exagamglogene autotemcel (Casgevy) and lovotibeglogene autotemcel (Lyfgenia) for eligible patients with sickle cell disease and, for Casgevy, transfusion-dependent beta-thalassaemia. These are one-off, curative-intent therapies delivered in specialist centres and offered to carefully selected patients.

  • Is CAR-T therapy available on the NHS?

    Yes, for selected relapsed or refractory B-cell lymphomas, acute lymphoblastic leukaemia and, more recently, multiple myeloma, through commissioned NHS centres. Referral is via a specialist MDT once eligibility criteria are met.

  • How can I support blood cancer patients if I am healthy?

    Joining the NHS Blood and Transplant register, donating blood and platelets regularly, and signing up to a stem cell registry such as Anthony Nolan or DKMS all directly help patients with anaemia, blood cancer and marrow failure.

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