Abnormal White Blood Cell Counts Flashcards
What is pancytopenia
All lineages reduced
What are the types of malignant haemopoeisis
Leukaemia (lymphoid, myeloid) = cancer of blood cells
Myelodysplasia = immature cells
Myeloproliferative = too many cells
Where are neutrophils found and how do they develop
Found in the peripheral blood
- myeloblast
- promyelocyte
- myelocyte
- metamyelocyte
- neutrophil (only one in the peripheral blood)
How are cell numbers controlled
Different cytokines will increase different cell numbers
DNA dictates differentiation and proliferation of blood cells
Which cytokines are involved in increasing cell numbers (erythroid, lymphoid and myeloid)
Erythroid - Erythropoietin
Lymphoid - IL2
Myeloid - G-CSF, M-CSF
Which cells are found in the peripheral blood
Immunocytes - T, B and NK cells
Phagocytes - granulocytes (neutrophils, eosinophils, basophils) and monocytes
Why may there be an increase WBC production
Reactive - infection or inflammation
Malignant - leukaemia or myeloproliferative
Why may there be a decrease in WBC production
Impaired bone marrow function - Aplastic anaemia - Post chemo - Metastatic cancer - Haematological cancer B12 or folate deficiency
Why may there be an increase in cell survival
Failure of apoptosis e.g. acquired cancer causing mutation in some lymphomas
Why may there be a decrease in cell survival
immune breakdown
What is the difference between primary and secondary causes of an elevated blood count
Primary = malignancy
Secondary = a normal response to stimulus
There is an elevated blood count of mature cells and all lineages are raised. What is the possible cause
Response to infection (secondary)
There is an elevated blood count of mature cells and only one lineage is raised. What is the possible cause
Response to infection (secondary)
There is an elevated blood count of mature cells and lymphocytes raised. What is the possible cause
Either chronic lymphocytic leukaemia (primary) or a response to viral infection
Describe the blood count of acute leukaemia
Elevated count of immature cells
Blasts are present
Platelets and Haemoglobin is low
Describe the blood count of chronic myeloid leukaemia
mix of mature and immature cells
Where are neutrophils found, what is their lifespan and what proportion are marginated
Present in bone marrow, blood and tissues
Life span = 2-3 days in tissues
50% circulating are marginated (stuck to vessels wall)
What is the cause of neutrophilia that develops in minutes
demargination
What is the cause of neutrophilia that develops in hour
Early release from BM
What is the cause of neutrophilia that develops in days
Increased production (x3 in infection)
What can cause primary neutrophilia
Myeloproliferative disorders (pre-malignant)
Chronic or acute myeloid leukaemia
What can cause secondary neutrophila
Inflammation (e.g.colitis, pancreatitis)
Infection
Physical stress (adrenaline, corticosteroids)
Underlying neoplasia
Give examples of infections which do not characteristically produce neutrophilia
Typhoid, brucella, and many viral infections
What may cause primary eosinophilia
Chronic eosinophilic leukaemia
What may cause secondary eosinophilia
Parasitic infestation
Allergic or autoimmune diseases e.g. asthma, rheumatoid, polyarteritis
Response to neoplasms e.g. Hodgkin’s lymphoma
Hypereosinophilic syndrome
What may monocytosis be seen in
Infections: tuberculosis, typhoid, brucella, VZV, CMV
Sarcoidosis
Chronic myelomonocytic leukaemia
What can basophilia be caused by
Pox viruses
What is the common name of infectious mononucleosis and what type of disease is it
Glandular fever/mono
Looks immature but is actually a reactive, infection induced lymphocytosis
Describe the action of infectious mononucleosis in the body
- Epstein-Barr virus (EBV) infects B lymphocytes using their CD21 receptor
- The infected B cell proliferates and expresses EBV-associated antigens
- Stimulation of a cytotoxic T lymphocyte (CTL) response
- Resolves the acute infection but a lifelong sub-clinical infection remains.
Describe what is detected in the Southern Blot Test
Ig and TCR genes undergo recombination in antigen-stimulated lymphocytes (B and T). Due to their primary monoclonal proliferation, all daughter cells have identical configurations of these genes
