ENBlood disorder treatment in Germany covers very different conditions, from anaemia to clotting problems in which the blood clots too poorly or too easily. They are treated by a haematologist, a specialist in blood formation in the bone marrow, the blood cells and the clotting system, who works out why a blood test is abnormal, where bruising comes from or why a clot formed unexpectedly.
This page is the overview of the Haematology section. Blood cancer, lymphoma and stem cell transplantation have their own pages and are only summarised and linked here.
Anaemia: When the Blood Carries Too Little Oxygen
Anaemia means the blood has fewer red cells or less haemoglobin, the oxygen-carrying protein, than normal, so the organs get too little oxygen. Typical symptoms listed in the WHO fact sheet on anaemia are tiredness, dizziness, headache, breathlessness on exertion and, in severe cases, pale skin and a fast pulse. Anaemia is a sign, not a diagnosis: behind it may lie a lack of iron or vitamins, hidden bleeding, chronic inflammation, an inherited condition or a bone marrow disease. So the haematologist looks for the cause first, because raising haemoglobin with tablets or transfusions alone leaves whatever lowers it untreated.
The most common forms are iron-deficiency and vitamin B12-deficiency anaemia. Iron is lost through heavy periods or unnoticed stomach and bowel bleeding, poorly absorbed in atrophic gastritis, coeliac disease or inflammatory bowel disease, and lacking in a poor diet. Vitamin B12 runs short with atrophic gastritis, after stomach or bowel surgery, in bowel diseases and on a strict plant-based diet, as it occurs almost only in animal foods. That is why haematologists work closely with gastroenterologists: the iron-deficiency anaemia guideline of the German Society of Haematology and Medical Oncology (DGHO) (in German, version of April 2025) requires the cause to be clarified in every case and, if there is no other clear explanation, a gastroscopy and colonoscopy.
Rarer are haemolytic anaemias, in which red cells are destroyed too early. They may be inherited, as in hereditary spherocytosis, or acquired, when the immune system attacks the body’s own red cells. In aplastic anaemia the bone marrow makes too few blood cells of two or all three types. Severe forms are treated in specialised centres with medicines that suppress the immune system or a stem cell transplant, described below.
Inherited Blood Disorders: Thalassaemia, Sickle Cell Disease, Haemophilia
Inherited blood disorders are written into the genes and usually appear in childhood: thalassaemia and sickle cell disease affect haemoglobin, haemophilia affects clotting. In thalassaemia too little haemoglobin is made; in sickle cell disease an altered haemoglobin makes red cells stiff and sickle-shaped when oxygen is low, so they block small vessels. Both are especially common in families from the Mediterranean, the Middle East, Africa and India, thalassaemia also in South-East Asia; carriers of the sickle cell gene historically survived malaria better. Severe thalassaemia needs regular transfusions, and the iron they bring builds up and damages the heart, liver and hormone glands, so it is removed with medicines. In sickle cell disease the focus is on preventing infections, especially in children, for example by vaccination, and on preventing painful crises, for which hydroxycarbamide is approved in the EU for adults and children over two.
Haemophilia and von Willebrand disease are inborn clotting disorders: a protein that stops bleeding is missing or works poorly — factor VIII in haemophilia A, factor IX in haemophilia B, von Willebrand factor in von Willebrand disease. Haemophilia is passed on via the X chromosome and mainly affects men; von Willebrand disease, the most common inborn clotting disorder, affects both sexes and in women often causes heavy periods. Treatment replaces the missing factor with a concentrate given into a vein, regularly or for bleeding; for haemophilia A, the EU has also approved a newer medicine that does the work of factor VIII and is injected under the skin. Surgery, and childbirth in women with von Willebrand disease or carrying the haemophilia gene, is planned in advance with a clotting specialist.
Paediatric haematology is a field of its own within paediatrics: children’s blood disorders are often inborn, and tests, doses and the treatment setting are geared to the child and the parents. One example is Dr. von Hauner Children’s Hospital of LMU Munich: its director, Prof. Christoph Klein, is a paediatric haematologist and oncologist, and its paediatric haematology, oncology and coagulation department also treats haemophilia and thrombosis.
Thrombosis, Thrombophilia and Platelet Disorders
A haematologist is needed when the blood clots too easily or platelets are too low or too high. Repeated clots or embolism, or a clot at a young age, without a clear trigger or in an unusual place such as the brain or abdominal veins, are reasons to see one; the haematologist decides whether to test for thrombophilia, an increased tendency to clot. Inherited forms include factor V Leiden and a lack of natural anticlotting proteins; the main acquired form is antiphospholipid syndrome, in which antibodies promote clotting. Testing is worthwhile when the result changes treatment: whether blood thinners are taken for a limited time or indefinitely, and whether prevention is needed in pregnancy. In antiphospholipid syndrome the result also changes the choice of medicine: the European Medicines Agency does not recommend the newer direct oral anticoagulants for patients who have already had a thrombosis.
In immune thrombocytopenia (ITP) the immune system destroys the body’s own platelets, the cells that first seal a damaged vessel, and hampers their production. This causes bruising, pinpoint bleeds in the skin, bleeding gums and nosebleeds, though some patients have no symptoms. Low platelets can also have other causes: infections, medicines, liver or bone marrow disease, or a lab artefact when platelets clump in the tube. Therapy depends not only on the count but on bleeding, age, other illnesses and the patient’s wishes. Sometimes watching is enough; corticosteroids (hormone medicines) usually come first, and in persistent disease medicines that stimulate platelet production and other options are discussed.
The opposite also happens: too many red cells or platelets. Usually another cause is behind it, such as smoking, lung or heart disease, sleep apnoea or dehydration for red cells, and iron deficiency, inflammation or infection for platelets. If none is found, the haematologist rules out myeloproliferative neoplasms, chronic marrow diseases that make too many blood cells, testing among other things for changes in the JAK2 gene. These are chronic blood cancers, covered briefly in the next section.
Blood Cancers and Stem Cell Transplantation
Blood cancers are tumours of the blood-forming and lymphatic system: leukaemias, in which immature cancer cells fill the bone marrow; myeloma, in which antibody-producing plasma cells multiply uncontrollably in the marrow; and myelodysplastic syndrome, in which the marrow produces defective blood cells. Their diagnosis and treatment are covered on the page on blood cancer treatment; lymphatic tumours have their own page on lymphoma treatment.
A haematopoietic, or blood-forming, stem cell transplant replaces diseased blood formation with healthy cells. The patient’s own cells can be collected and returned after high-dose chemotherapy, for example in myeloma and some lymphomas. Donor cells from a sibling or an unrelated registry donor are used in acute leukaemias and myelodysplastic syndrome and, among non-cancerous conditions, in severe aplastic anaemia, thalassaemia and sickle cell disease. A transplant centre decides whether and which transplant is suitable; more on the page on stem cell transplantation.
Frequently asked questions
When should you see a haematologist?
See a haematologist when blood count changes persist without explanation: anaemia without a clear cause, platelet, white or red cell counts that are too low or too high, easy bruising or bleeding, or a clot at a young age or a repeat clot. An inherited blood disorder in the family, such as thalassaemia or haemophilia, is another reason, especially before a pregnancy or an operation.
Can thalassaemia or sickle cell disease be cured?
Not for everyone: for most patients it is a chronic condition controlled for years with transfusions, iron removal and crisis prevention. A donor stem cell transplant, ideally from a matched sibling, can remove the cause but carries serious risks. A gene therapy using the patient’s own cells has conditional EU approval for some patients 12 years and older who are suitable for a transplant but have no matched related donor. A specialised centre decides.
Does thrombophilia need treatment if you have never had a clot?
Usually not: without a previous clot, permanent blood thinners because of thrombophilia alone are not recommended. What matters are higher-risk situations such as surgery, pregnancy and childbirth, and the choice of hormonal contraception. For some particularly high-risk forms, the doctor may prescribe prevention during such periods or advise another contraceptive method. Testing everyone for thrombophilia before prescribing the pill is not recommended.
How much does blood disorder treatment in Germany cost?
There is no single price: it depends on the diagnosis, the tests and whether a hospital stay, transfusions, expensive medicines or a stem cell transplant are needed. The hospital first reviews the records and issues a cost estimate listing the tests, treatment and amount. Quoting a price before a doctor has seen your results would be guesswork, so start by sending the documents.
How AlenMed Arranges Blood Disorder Treatment in Germany
AlenMed selects a haematology department based on your records and arranges the trip, and treatment starts with a haematology work-up: a full blood count and a smear examined under the microscope, iron, vitamin B12 and folic acid levels, clotting tests and, where needed, bone marrow sampling and molecular genetic tests. The doctor chooses the tests based on your symptoms and existing results, and the hospital says how long results take.
Haematology departments exist at university and large hospitals across Germany. At Munich Hospital Bogenhausen (München Klinik Bogenhausen), Prof. Tobias Herold is chief physician of the Department of Haematology, Oncology, Stem Cell Transplantation and Palliative Care. At the Red Cross Clinic in Munich, Prof. Marcus Hentrich is chief physician of Internal Medicine III (Haematology and Oncology). At Klinikum rechts der Isar of the Technical University of Munich, Prof. Florian Bassermann directs the Department of Internal Medicine III, which treats benign and malignant blood diseases. Essen University Hospital has a Department of Haematology and Stem Cell Transplantation.
For a first assessment, send blood tests covering several months or years, discharge letters, bone marrow reports if available, and a list of transfusions and medicines with doses. The records are translated into German; if there is already a diagnosis, you can start with a second opinion in Germany based on them. The hospital issues an official cost estimate (Kostenvoranschlag), and AlenMed helps with the visa invitation and provides an interpreter at appointments. The company’s office is in Munich.
This material is for reference only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation.