Haematology

Haematology encompasses the physiology and pathology of blood and its cellular components. Erythropoiesis in the bone marrow yields red cells that transport oxygen via haemoglobin; leucopoiesis produces granulocytes, monocytes and lymphocytes responsible for innate and adaptive immunity; and megakaryopoiesis generates platelets that maintain vascular integrity and drive haemostasis. Coagulation is orchestrated through sequential activation of clotting factors, culminating in thrombin-mediated fibrin formation and clot stabilisation. Disorders of haematopoiesis span anaemias, myeloproliferative and lymphoproliferative neoplasms, inherited haemoglobinopathies and acquired coagulopathies. Transfusion medicine and novel blood substitutes address deficits in oxygen-carrying capacity, while viscoelastic tests and thrombin generation assays guide personalised management of bleeding and thrombosis. Advances in molecular diagnostics, targeted therapies and stem cell transplantation continue to reshape the field, improving outcomes across benign and malignant blood disorders.

Research from Nature Portfolio

Control-oriented phenomenological models have been developed to predict viscoelastic clot parameters from rapid blood protein measurements. By mapping plasma proteins to thromboelastography (TEG) curves, these models forecast functional fibrinogen, native and platelet-mapping assay outputs in minutes rather than the customary tens of minutes, laying the groundwork for automated, real-time coagulation control systems. Quantitative analysis of thrombin at clot time (TCT) across thousands of simultaneous thrombin-generation and clot-formation assays revealed that TCT often approximates ten per cent of peak thrombin yet varies with procoagulant phenotype. This study demonstrated that TCT provides complementary information to clotting time and peak height, offering a novel marker of plasma procoagulant potential. Earlier foundational work introduced thrombin dynamics, distinguishing prothrombin conversion from inactivation and showing that variation in factor X and antithrombin levels chiefly modulates thrombin generation, thereby illuminating mechanistic drivers of altered haemostasis in conditions such as liver cirrhosis and renal failure.

Haematology publication trend

The graph below shows the total number of articles in haematology across all publications each year (not limited to Nature Index journals).

Technical terms

Erythropoiesis: The process by which red blood cells are produced from haematopoietic stem cells in the bone marrow.

Haemostasis: The sequence of events—vasoconstriction, platelet plug formation and coagulation—leading to cessation of bleeding.

Thromboelastography (TEG): A viscoelastic assay measuring clot initiation, formation, strength and lysis in whole blood, used to guide haemostatic therapy.

Thrombin generation assay: A test quantifying the rate and amount of thrombin produced in plasma, providing global assessment of coagulation balance.

Thrombin at clot time (TCT): The concentration of thrombin present at the instant of fibrin clot formation, reflecting procoagulant phenotype.

Prothrombin conversion: The enzymatic cleavage of prothrombin to generate active thrombin, a central step in the coagulation cascade.

Haemoglobin-based oxygen carrier (HBOC): A therapeutic agent composed of free or modified haemoglobin designed to transport oxygen in place of erythrocytes.

PEGylation: The covalent attachment of polyethylene glycol chains to proteins or particles to prolong circulation half-life and reduce immunogenicity.

References

1. Quick model-based viscoelastic clot strength predictions from blood protein concentrations for cybermedical coagulation control. Nature Communications (2024).
2. Investigation of thrombin concentration at the time of clot formation in simultaneous thrombin and fibrin generation assays. Scientific Reports (2024).
3. Deciphering the coagulation profile through the dynamics of thrombin activity. Scientific Reports (2020).
4. Taming hemoglobin chemistry—a new hemoglobin-based oxygen carrier engineered with both decreased rates of nitric oxide scavenging and lipid oxidation. Experimental & Molecular Medicine (2024).
5. Nanomaterial-related hemoglobin-based oxygen carriers, with emphasis on liposome and nano-capsules, for biomedical applications: current status and future perspectives. Journal of Nanobiotechnology (2024).
6. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Critical Care (2023).