Please Do Call Us Classical Hematologists

The recent decision by the American Society of Hematology (ASH) Executive Committee to adopt formally and uniformly the term “classical hematology” instead of “benign” or “non-malignant” hematology to describe the areas of hematology not dealing with blood cancers could not have come at a better time. It is the perfect time for us to rename and rebrand our field.

After decades of neglect, with historically poor recruitment, retention, and mentorship, classical hematology is now on the brink of a renaissance on an unprecedented scale.¹  ASH has just launched a $19 million pilot program to expand hematology-focused fellowship training across the United States, with the goal of training dozens of new classical hematologists over the next several years.²  Every day, cutting-edge discoveries bring forth new scientific advances in numerous classical hematologic diseases, including sickle cell disease, thalassemia, hemophilia, and many others. We have proudly referred to ourselves as classical hematologists for years, and we applaud the ASH Executive Committee’s endorsement of this term, which has already begun eliminating the brand confusion that has long plagued our field.³  “Classical hematology” is an accurate and respectable term for practitioners and patients that celebrates the rich history of our field, including centuries of scientific advances central to every aspect of medicine.⁴  We believe it is the best term for our future, too.

With this in mind, we appreciated reading Dr. Steven Lentz’s differing perspective on the newly embraced nomenclature, as well as ASH President Dr. Robert Brodsky’s thoughtful reply, in a recent issue of The Hematologist.⁵  Among Dr. Lentz’s criticisms was the fact that a ChatGPT search he performed erroneously attempted to draw distinctions between “classical” and “modern” hematology. However, as the existence of ChatGPT reminds us, the future is coming quickly. In fact, we posed Dr. Lentz’s question, “What is classical hematology?” to the most recent version of ChatGPT only months after he did, and it had already corrected its prior inaccuracies:

We couldn’t have said it better ourselves. This might be a rare occasion when the speed of ChatGPT’s evolution has been less impressive than that of actual humans. Just one year has passed since the publication of our Viewpoint article in The Lancet Haematology and the ASH Executive Committee’s decision to standardize the terminology, and we have witnessed positive sentiment already — among our colleagues within and outside of the subspecialty, our patients, and, very crucially, our trainees. Those trainees, whose upcoming career decisions are what matter most, have consistently lauded the change. As one of our hematology-oncology fellows put it: “Classical hematology sounds classy. ‘Classical hematologist’ just exudes master clinician, like a Dr. House-type diagnostician.” Or, as one of our internal medicine residents commented: “It’s ‘classical hematology’ now? That’s definitely an upgrade — best name change since BackRub became Google. Honestly, ‘benign hematology’ might as well have been ‘boring hematology.’” Words matter to the trainees who are hematology’s future. They also matter to patients, and even donors. Just ask your institution’s development office if they recommend approaching philanthropic donors with requests to fund “benign hematology” research.

But, as much as words matter, actions and results are always more important. While it will take years to objectively evaluate the potential benefits of this nomenclature standardization, we were heartened to hear in Dr. Brodsky’s response to Dr. Lentz that ASH is already seeing an increase in training grant applications in classical hematology. We have witnessed the same increase in interest over the past year at our own institutions and heard similar positive feedback from our colleagues at other institutions. This has convinced us that “classical hematology” is the best term for our field and its future.

So, given all of this, please do call us classical hematologists. (Or “classy hematologists” — that one is fine by us, too.)

Author notes: The authors thank Kal Clark, MD, of the University of Texas San Antonio, for his assistance with GPT-4. Dr. Al-Samkari is funded by the National Heart, Lung, and Blood Institute (1K23HL159313) and is the recipient of the American Society of Hematology Scholar Award. Dr. Lee is supported by the DeLuca Center for Innovation in Hematology Research at Yale, The Frederick A. DeLuca Foundation, contributions by Jack Levin, MD, and an anonymous donor to the Classical Hematology program at Yale.