Download - White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital
![Page 1: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/1.jpg)
White blood cells and their disorders
Dr K HamptonHaematologist
Royal Hallamshire Hospital
![Page 2: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/2.jpg)
Normal white cells
• Mature cells circulate in blood
• Produced from immature precursor cells in the bone marrow, derived from stem cells.
• Rate of production under hormonal control by series of growth factors.
![Page 3: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/3.jpg)
Neutrophils
• Most numerous white cell, lifespan 10 hours• Phagocytose and kill bacteria• Release chemotaxins and cytokines,
important in inflammatory response
• Lack of number or function results in recurrent bacterial infections
![Page 4: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/4.jpg)
Monocytes
• Produced in bone marrow, transit through blood for 20 hours and enter tissues as macrophages
• Some become dendritic cells that present antigens to the immune system
![Page 5: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/5.jpg)
Basophils
• Relatively rare in peripheral blood• Migrate to tissues to become mast cells• Contain granules of histamine• Surface IgE• Important in immunity and allergy
![Page 6: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/6.jpg)
Eosinophils
• Also rare in peripheral blood• Impotant in inflammation and allergic
responses• Special role in protection against parasites
![Page 7: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/7.jpg)
Lymphocytes
• Vital to immunity• Some generate antibodies against specific
foreign antigens, eg bacteria, viruses• Other have phenomenon of immunological
memory, generates immunity and allow vaccination
![Page 8: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/8.jpg)
B lymphocytes
• Named after Bone marrow• Differentiate into plasma cells and produce
immunoglobulins when stimulated by expose to a foreign antigen
![Page 9: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/9.jpg)
T lymphocytes
• Named after Thymus• Some are helper cells (CD4)• Some are cytotoxic cells (CD8)
• Aid B cells in antibody generation and also responsible for cellular or cell mediated immunity
![Page 10: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/10.jpg)
Immunodeficiency
• Congential or acquired immunodeficiency very serious condition, often fatal
• Congenital immunodeficiency treated with bone marrow transplant or gene therapy
• HIV virus causes AIDS due to infecting CD4 lymphocytes and leads to opportunistic infections
![Page 11: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/11.jpg)
Bacterial infections
• Result in neutrophilia: increase in neutrophils
• Engulf and kill bacteria• Failure results in overwhelming infection
• Can aid neutrophil response with G-CSF, a specific growth factor for neutrophils
![Page 12: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/12.jpg)
Viral infections
• Response by lymphocytes• Generate immunoglobulins and memory
cells• Usually only have infection once• Severe infections like hepatitis B and
Meningococcus C can be prevented by vaccination: generates memory B cells
![Page 13: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/13.jpg)
Acute leukaemia
• Proliferation of primitive precursor cells usually only found in bone marrow
• Proliferation without differentiation
• Replaces normal bone marrow cells, leads to: anaemia: palor and lethargy
neutropenia: infection thrombocytopenia: bleeding
![Page 14: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/14.jpg)
Acute myeloblastic leukaemia (AML)
• Malignant proliferation of the precursor myeloblasts in the bone marrow
• Disease primarily of adults: 50% survive 5 years
• Treatment is with cyclical high dose chemotherapy and possibly bone marrow transplantation
![Page 15: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/15.jpg)
Acute lymphocytic leukaemia(ALL)
• Malignant proliferation of the lymphoblast precursor cells in the bone marrow
• Disease primarily of childhood: 80% cure
• Treated with cyclical chemotherapy over 2-3 years, CNS specific treatmentTransplantation only if relapse
![Page 16: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/16.jpg)
High grade lymphoma
• Classified as Hodgkins disease and Non-Hodgkins lymphoma (NHL)
• Disease usually of lymph nodes that spreads to liver, spleen, bone marrow and blood
• Needs aggressive curative chemotherapy
• Localised disease may be treatable with radiotherapy
![Page 17: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/17.jpg)
Chronic leukaemia
• Malignant proliferation with differentiation
• Overproduction of mature cells, not precursor blast
• Untreated has better prognosis, hence called chronic, commoner in older age
![Page 18: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/18.jpg)
Chronic lymphocytic leukaemia
• Proliferation of mature lymphocytes, usually B lymphocytes
• Lymphocytosis in blood, lymphadenopathy, splenomegaly
• Prognosis measured in years to decades, treatment with out patient chemotherapy
![Page 19: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/19.jpg)
Chronic myeloid leukaemia
• Proliferation of mature myeloid cells: neutrophils, also basophils and eosinophils
• Philadelphia chromosome, t9:22 specific chromosomal translocation
• Can be cured by bone marrow transplantation in younger age group
![Page 20: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/20.jpg)
Low grade leukaemia
• Chronic proliferation of mature lymphoid cells of lymph node origin
• Disease principally of elderly, survival years to decades
• Treatment, when necessary, = out patient chemotherapy
![Page 21: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/21.jpg)
Multiple myeloma
• Malignant proliferation of plasma cells in bone marrow
• Plasma cells are B lymphocytes that produce immunoglobulin
• Myeloma has monoclonal immunoglobulin in serum and urine
![Page 22: White blood cells and their disorders Dr K Hampton Haematologist Royal Hallamshire Hospital](https://reader035.vdocument.in/reader035/viewer/2022062601/5a4d1bd47f8b9ab0599d9bb0/html5/thumbnails/22.jpg)
Multiple myeloma
• Lytic lesions in bones, with pain or pathological fracture
• Hypercalcaemia with thirst, polyurea and confusion, due to bone resorption
• Hyperviscosity due to immunoglobulin
• Renal failure