Disease of White Blood Cells

LymphNodes spleen and thymus

component
of Hematopoietic system myeloid tissue

Lymphoid tissue

myeloid tissue Bone marrow and cell derived from it

Eg RBC platelet granulocytes Monocyte

Neutrophil

Basophil

Eosinophil

lymphoid tissue LN thymusspleen

Thissubdivision is artificial with Respect to bothNormal

physiology
Hematopoietic cue and disease affecting them

of

Tt is Not possibleto draw Neat lines betweendiseases

involvingthe myeloid and lymphoid tissue

Eg Bonemarrow contain Relatively few lymphocytes and

of an lymphoid Progenitor and long lived plasma

memory lymphocyte

Egs Neoplasticdisorder

in Bone
of myeloidprogenitor
Marrow But secondarily
myeloid
leukemia
involvespleen

originate

and
lymph Node

Eg Some Red cell disorder ImmunoHemolytic

Anemia Result

from formation
of disorder
autoantibody indicating a primary

of lymphocytes

Development and Maintenance of

Hematopoietictissuey

3rd week Blood cell Progenitor yolk say

3month Hsc Mesoderm

gonad mesonephros
t migrateto lives

Unhot Shortly before birth

onytatshwmfou.inu.ua

4thmonth
migrateto BoneMarrow

Till puberty Hematopoieticallyactive Marrow are

found throughout the Skeletal

Test

Yolk sac is source of long lived tissue Macrophages

But contributionofYolksac to Blood formation Mainly in

theformof embryonicRed cell which is only tzanaient

Note Also
during 3rd month during the Conroeof
Migrationof Hse to live it also takeup Residence

in thefetal placenta whichhas clinical use in

Hse transplant from umbilical cord

Hemato self

posing
cell
i MAE

u
t E gergo

B o e

is mpgghkhihm
wa.DE
T

e to

Toye progenitor
Early progenitor

Noithlymphoid 8 with

potential myeloid

a 8 Potential

s.ioB Pro i

pro Bo Cree mix cr ulblmk.EE

Nkaeeef Btell

8
f of bumphotoing
ee
JIM E
Cfa crab
T
to Cree
Pse cry

camo
Pre EO Meg E

Prema
8

wee EE Boell Twee V

I anI I.n

mtmv.am

Hematopoietic stemaeeecnsg twopropelh.es

Reunifeng Renewalcapacity

elf do

I one daughteeceee

to
Ability generate

all maheleBlood Must Self Renew

cell to avoid depletion

of sternum

condition like Maskedstress

these severeanemia

AcuteInflammation

Hsc

mobilise

to Peripheral

Hse used in transplantation are now mainly Blood

collected from Peripheral Blood donor

with
of factor GCSD

treated granulocyte colony stimulating

Erythropoietin Thrombopoietin LGM CSD CSD

on commited
only

progenitor

Stem cell factor KIT Ligand and FLT 3

actthrough Receptors that are expressed on

comiteed progenitor Like Multiple

very early Progenitor

Hematopoieticstem cell
give Rise to several kind of

early progenitor
types of

These Rise to specific

early progenitor give

Cal Kfa Colony forming unit cry

from various comitted progenitor are derived

Me precursor such
Morphologically Recognizable
as

myeloblast Megakaugoblast eh

The Marrow Response toshort term physiological needs

is Regulated Hematopoietic Growth factor through

by
effect on the comitted progenitors

Hsc give Rise to Multiple progenitor

Hsc multipleprogenitor

proliferative more proliferative than Hsc

more capacityof lesscapacity Renewal

of self

SelfRenewal

Diseases alter the production of Bloodcells

A outputof 4 outputof

granulocyte

gragulocyte

4h9m

Inflammation

primaay most important

diseases that interfere with Marrowfunction

genetic disease

Also
to production

Infection of

toxin Bloodcell the

Nutritional deficiencies by

Marrow

ChronicInflammation

Tumorof Hematopoietic origin associated with Mutation

that block progenitor cue maturation or abrogate

their growth factor dependence

Leteffect

untegulated clonal Expression

Replaces Normal Marrow

to

often spread to other Hematopoietictissues

Tumor Transformed
mayoriginate from

Hsc

abilityto origin is

differentiate a more different

along Multiple Iated progenitor

lineages thatacquire

abnormal

capacity for

Seif Renewal

BoneMarrow microenvironment

Release

orderlyproliferation differentiation
of Blood cell

filledwith a Networkof thin walled sinusoid

linedby singlelayerof endothelial cell and discontinuous

Basement Membrane

TnInterstitium lies cluster Hematopoietic cell and

of

future

Differentiated Blood All enter thecirculation by

Transcellular migration via

megakaeyocyte lie Nextto sinusoid andextend

stream to produce platelet

RedCell Surrounds Macrophages Nurse cell

provide fe Needed for Hb synthesis

disorder can cause

Metastaticcancer orgranulomatous

immature precursor into the

abnormal Releaseof
peripheral blood a finding that is

Referred to as

leuckoerythroblastosis

MamaoAspirates Bestassessment ofMorphology

ofHsc

Immature precursor Blastfound

t
morphologicallysimilar

50 Mustbe identified

definitively using lineage specific antibody

and his tochemical Markers

Mature precursorcan be identified based

on their morphology alone

Biopsied are a
good means for estimating marrow

activity

In normal adults theRatioof fatcells to

elementis 1 1

in Hypoplastic state Eg Aplastic anemia the proportion

of fit cell is increased

greatly

In Hematopoietictumor and disease characterised

compensatory Hyperplasia Eg HemolyticAnemia

and Neoplastic proliferation such as leukemias

fatale de's


Metastah's cancer and disease

granulomatous

induce local marrow fibrosis

touch lesion are irrespirable and

Best in
seen
usually

Biopsy

Disorder of white Blood cell

proliferative disorder Lenkopenias

b l

Leucocytosis
Expansionof leukocyte deficienciesof

Io leukocyte

Reach've Neoplastic

I
selfing of infection

so

or inflamotoery process

Leucopenia tse No
of white
circulating cell
usually Resent

from Neutropeniagranulocytope
Tia

fommon

caked Lymph opensas less

Autoimmune disease

Congenital Immunodeficiency disease

HIV Infection
or

cytotoxicdrug glucocorticoidtherapy

Malnutrition
certain Acute viral Infection But Here
Leuk ta

Perrier

is due to

Il I 7 Achieve Thee INFV Redistribution

team

Changes the expression ofsurface protein that Regulate

Fae migration f
Thesechanges Resent in the sequestration
of

activated Tolls in lymphNode and lased

adherence to endothelial cell

to

Bothof which contribute to lymphopenia

Granulocytopenia is oftenassociated with diminished

choir

granulocyte fun

Neutropenia D tu sein number of Neutrophil

clinicallysignificantReduction in Neutrophil

Agranulocytosis
most common cause of
agranuloc tosis

is

drug toxicity

f Aseddestruction
of Neutrophils in

Inadequate theperiphery

Ineffective

granulopoiesis
variety ofMfume

suppression oftescCAplasticanemia

Marrowdisorder tremorgranulomatous

disease
fanemia
of

Suppression thrombocytopenia
comimed
granulocyte premiere

drug

Disease associated E ineffective Hematopoiesis

Precursordie in
Manaus

Eg Megalo plasticAnemia MDs

Rarecongenital condition Kostmann Syndrome

Inheriteddefect

Specific gene impair

granulocytic differentiation's

Accelerated destruction or sequestration

of Neutrophils

Tenmunologically mediated Tanguay to Neutrophils SLE

splenomegaly a splenic enlargement

sequestration ofNeutrophil

Moldest

Neutropenia

sometime

Inanda and
thrombocytopenia

Increased peripheral utilization

to

over whelming bacterial fungal or

Rickensial Infection

Note

Arguing agent
Antimetabolite CusedinCancer they

produce agranulocytosis

0 indotseRelated fashion

of
generalisedsuppression Hematopoiesis

Aminopyrine chlorpwmarinet Toxic effect on

ftp.mnpaohmen.ifltphienyewaulwawne granulocyte precursor

Sulfonamides Antibody Mediated destruction of

Mature Neutrophil

Othercause Neutropenia Occurs in association c

Monoclonal proliferation

of large granular

lymphocytes so called LGL leukemia

Mechanism not clear

progenitorbyproductof the Neoplastic cell usually

81 cytotoxic likely

BoneMarrowpicture

when the destruction at Reeef

Hyperaellularity of Ineffictivegsanueopoiesis

Megaloblastic

Anemia

agent that

caused

Hypocelluraliyo Agranulocytosis

destyo granulocyte precursor

Clinicalfeahues stafection

Malaise

Chill

fever
weakness

fatigability

Agranulocytosis

Serious Infection
5001mm's Neutrophil

TIED Antibiotics Breadspectrum

Myelosyppressive chemotherapy G Csf