Haematology 11: Abnormal White Cell Count Flashcards
As myeloblast matures, it becomes _____
and
its cytoplasm becomes _____
As myeloblast matures, it becomes SMALLER
and
its cytoplasm becomes CLEARER
Factors stimulating and controlling cell no. for:
Myeloid =
Lymphoid =
Erythroid =
Factors stimulating
Myeloid = G-CSF + M-CSF
Lymphoid = IL2
Erythroid = Erythropoietin
Lymphocytes Myeloblasts Promyelocytes Myelocytes Metamyelocytes are found in =
Lymphocytes Myeloblasts Promyelocytes Myelocytes Metamyelocytes are found in = THE BONE MARROW
Immunocytes (T / B lymphocytes + NK cells)
Phagocytes (Granulocytes + monocytes)
are found in =
Immunocytes (T / B lymphocytes + NK cells)
Phagocytes (Granulocytes + monocytes)
are found in = peripheral blood
What might cause an increase in WBC cell production?
(reactive)
- Infection
- inflammation
(malignant)
- leukaemia
- myeloproliferative
What might cause an increase in WBC cell survival?
- failure of apoptosis
e. g acquired cancer
What might cause a decrease in WBC cell production?
- impaired bone marrow function
- B12/folate deficiency
- bone marrow failure
- aplastic anaemia
- post chemotherapy
- metastatic cancer
- hematological cancer
What might cause a decrease in cell survival?
- immune breakdown
What are the 2 general causes of an increase in WBC count?
- reactive
2. primary (malignant)
In chronic myeloid leukemia, mutation occurs at the _____ phase
GM-CFC phase
(granulocyte-monocyte colony forming cell) phase
List methods of investigating a raised WCC
- history + examination
- Hb and platelet count
- automated differential
- examine blood film
If there are any immature cells in the blood film –>
If there are any immature cells in the blood film –> might be leukaemia
In a normal reactive response to infection/inflammation, would you get immature cells in the peripheral blood?
- NO
if you get ONLY immature cells + low hb + low platelets –>
if you get ONLY immature cells + low hb + low platelets –> might be acute leukemia
What is a normal full blood count?
Hb Platelets WCC Neutrophils Lymphocytes Monocytes Eosinophils Basophils
Hb 120-160g/L Platelets 150-400 x10^9/L WCC 4-11 x 10^9/L Neutrophils 2.5-7.5 x 10^9/L Lymphocytes 1.5-3.5 x 10^9/L Monocytes 0.2-0.8 x 10^9/L Eosinophils 0.04-0.44 x10^9/L Basophils 0.01-0.1 x10^9/L
50% of circulating neutrophils are marginated.
What does it mean by “marginated”?
marginated = they have stuck onto the wall of a damaged vessel
Give some causes of neutrophilia
causes of Neutrophilia:
(reactive)
- infection
- tissue inflammation
- corticosteroids
- underlying neoplasia
(malignant)
- CML
- myeloproliferative disorders
How do you tell if someone has Hodgkin’s disease (on X-ray) ?
Describe its onset.
hodgkin’s disease –> increased mediastinal mass on the chest x-ray
onset:
- there is secretion of IL-5
- which stimulates reactive eosinophilia
OR
- you get mutation of GM-CFC eosinophilia
- which expands the eosinophils
What are some primary causes of lymphocytosis ?
- monoclonal lymphoid proliferation
- e.g chronic lymphocytic leukemia
What are some secondary causes of lymphocytosis ?
- polyclonal response to infection, chronic inflammation / underlying malignancy
What are some causes of reactive lymphocytosis?
- infection
- autoimmune disorders
- neoplasia
- sarcoidosis
Describe the onset of Glandular fever
- EBV infection of B lymphocyte occurs
- via CD21 receptor
- Infected B cell proliferates
- and expresses EBV associated antigens
- Cytotoxic T-lymphocyte response
- Acute infected = resolved
- resulting in lifelong sub-clinical infection
glandular fever = more common amongst
glandular fever = more common amongst young people
In older patients, lymphocytosis is more commonly caused by __________.
In older patients, lymphocytosis is more commonly caused by chronic lymphocytic leukemia
