Myeloid lineage cell stages in granulocytic maturation: Flashcards
What is the characteristics of the myeloblast?
- not present in p blood
- 2-4% of cells in marrow
- pale blue
- big nucleoli
An increase in the number of myeloblasts in the marrow can be an indicator of?
Anything more than 5% in the blood can be an indicator of leukemia - acute myeloblastic leukemia.
What are the characteristics of promyelocytes?
- not present in p blood
- occasional nucleolus
- deep blue cytoplasm in colour
- contains p granules
What are the characteristics of myelocytes?
- not in p blood
- no nucleoli
- secondary granules present in cytoplasm
- Maturation
What are the characteristics of the metamyelocyte?
- low nucleocytoplasmic ratio
- distinctive p and s granules
- nucleus becomes curved without being lobed and will mature in band neutrophils which are referred to by some as stab cells.
What are metamyelocytes referred to as once the nucleus has become curved without being lobed during maturation?
Band neutrophils.
What are the characteristics of the neutrophil?
- rich in granules
- hypersegmented (right shift)
3-5 lobees, connected via chromatin strands. - < 2 lobes = hypersegmented the Pelger Huet anomaly is an example of this.
What is an example of a neutrophil population with 2 lobes or fewer?
Pelger-Huet anomaly.
What is neutrophil lecocytosis?
An increase in neutrophils - greater than 7.5 x10^9/L.
What are some of the causes that are are associated with neutrophilia?
Fever, inflammatory process, acute haemorrhage, drugs, chronic myeloid leukemia.
What does neutrophilia cause in the blood?
A shift to the left - as there is an increase in the number of band neutrophils and occasionally metamyelocytes in the blood.
What is toxic granulation?
This is the presence of really dark granules and Dohle bodies (light pale blue inclusions)
It is an increase in immune response
What is NAP score?
This is the Nuclein alkaline phosphatase which involves the making of a blood film, stain (which the enzymes within the neutrophil will react with and cause a colour deposit)
How does one do a NAP score?
Count 100 cells, score from 0-4
How is neutrophilia treated?
With myeloid growth factors : g-csf, gm-csf.
What is asplenia?
absence of normal spleen function and is associated with some serious infection risks.
What is Leukemoid Reaction?
This is a white cell count > 50x10^9/L with cells of all myeloid maturation occuring in the p blood.
What is neutropenia?
this is when the neutrophil count is 2.5x10^9/L.
What happens when the absolute neutrophil level falls below 0.5x10^9/L?
The patient is likely to have recurrent infection.
What happens when the neutrophil count falls to less than 0.2x10^9/L ?
The risks are very serious, especially if there is also a functional defect.
What is generally pancytopenia?
This is when a person has low blood counts for all blood cells (3 types)
Conditions: Asplastic anaemia.
What are the congential causes of neutropenia?
Kostmann’s syndrome - this is an early life presenting with a count of less than 0.2x10^9/L with life threatening infections.
What is Kostmann’s syndrome assocaited with?
Mutations with the gene encoding for neutrophil elastase.
What are the acquired causes of neutropenia?
- drug induced (antibacterial, direct toxicity or immune)
- Cyclical neutropenia (oscillating neutrophil and monocyte counts)
- immune - autoimmune and SLE
