White Cell Disorders

Question 1

What are leukocytes?

Answer 1

Make up <1% of total blood volume 4 – 11 x 10^9/L of blood

Function in defense against disease
- leave capillaries via diapedesis
- move into blood by ambeoid movement where they squeeze
between cells in the epithelium. Move by positive chemotaxic
force, particularly IL8.

Leukocytosis: WBC count over 11 x 10^9/L
- can be normal response to infection
- caused by inflammation and infection - bacterial will lead to a
rise in neutraphils, where as viral leads to a rise in lymphocytes

Question 2

What is the order of leukocytes in the blood?

Answer 2

Neutrophils > lymphocytes > monocytes > eosinophils > basophils

Question 3

What are common white cell disorders?

Answer 3

Leucopenia- low white cell count usually low neutrophils
(neutropenia)

Leucocytosis- increased white cell count, may be reactive to
infection or inflammation

Leukaemias- malignant (neoplastic) proliferation of white cells or their precursors

Lymphomas- lymphoid neoplasms

Multiple Myeloma- a plasma cell neoplasm

Question 4

What is the classification of leukaemias?

Answer 4

Acute:
Rapid onset, often without elevated WBC count. Leads to lots of immature cells, i.e. early progenitor cells, caused by a block in differentiation. Leads to rapid onset and death.
— AML
- see an increase in myeloblasts
— ALL
- see an increase in lymphoblasts

Chronic:
Insidious - subtle initial stages, but accelerates throughout later stages.
Early stage diagnoses tend to be prevalent in elderly. Elevated mature cell. 
— CML
- All the stages of differentiation seen
- see an increase in myelocytes/granulocytes
— CLL
- see an increase in lymphocytes

Question 5

What is a lymphoma?

Answer 5

Lymphoma is cancer that begins in cells of the lymph
system

Lymphoma can occur in both children and adults

The two main types of lymphoma
– Hodgkin lymphoma 
      - average 15-25 age
      - direct relation to glandular fever - EGV pathogenesis!
      - better in terms of survival rate
– non-Hodgkin lymphoma (NHL)
      - e.g diffused large B cell disease
      - rare and tend to be in elderly

Question 6

What is multiple myeloma?

Answer 6

A malignant B-cell tumour that is distributed at several sites within
the bone-marrow compartment

A plasma cell neoplasm
- Plasma cells are antibody secreting cell
- will see loads of antibodies (specific IgG, so as a compensatory
mechanism, often see less of the other)