Blood and its components Part 2
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1. White blood cells (leukocytes) include granulocytes like neutrophils, eosinophils, and basophils which fight infection, and agranulocytes like monocytes and lymphocytes which are involved in immune responses. 2. Leukemia is a cancer of the blood cells characterized by abnormal proliferation of white blood cells. The four main types are acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, and chronic lymphocytic leukemia. 3. Factors involved in leukemia development include genetic mutations, chromosomal translocations, radiation exposure, certain chemicals, and some viruses. Maintaining overall health can help support white blood cell counts.
Blood and its components Part 2
- 1. Blood andIts Components (Part - 2) By: Dr. Arun Panwar
- 4. Functions ā¢ Neutrophils: Phagocytosis of Organisms ā¢ Eosinophils: Combat the effect of histamine in allergic reactions, kill parasitic worms. ā¢ Basophils: Release heparin, histamine and serotonin in allergic reactions that promote overall inflammatory response. ā¢ Monocytes: Phagocytosis( after transforming into macrophages) ā¢ Lymphocyte: Mediate immune responses
- 5. Classification ā¢ 1. Granulocytes-with granules ā Neutrophils, ā Eosinophils and ā Basophils ā¢ 2. Agranulocytes-without granules. ā Monocytes and ā Lymphocytes
- 6. Normal range of WBC
- 13. Neutrophils NEUTROPHILS ļ§ Their main function is to recognise, ingest and destroy foreign particles and microorganisms. ļ§ Everyday 1011 neutrophils enter the circulation. ļ§ They spend 6-10 hours in the circulation before being removed, mostly by the spleen ļ§ Alternatively, they pass into the inflammatory process or undergo apoptotic cell death and phagocytosis by macrophages. ā¢ Size : 10- 14 Āµ diameter ā¢ Nucleus: Usually multilobed ā¢ Cytoplasm : Fine pink granules
- 14. Neutrophilia Depression Exercise lactation pregnancy Infections, especially bacterial Acute haemorrhage, Burn, trauma, shock Leukemia Stress, Smoking Neutropenia Typhoid, paratyphoid HIV infection Aplastic anemia Hypersplenism Viruses: Measles, Influenza Marrow inļ¬ltration Sepsis
- 15. Drugs That Induce Neutropenia
- 16. Eosinophils red, have ā¢ Size : 10- 14 Āµ diameter ā¢ Nucleus : purple, bilobed ā¢ Cytoplasm : acidophilic ā¢ Granules : coarse, bright lysozymes ā Major basic proteins (MBP) ā Eosinophil peroxidase ā Eosinophilic cationic proteins (ECP)- neurotoxin Life span : 7-12 days Normal Eosinophil arrowed with normal neutrophil.
- 17. Eosinophilia: ā¢ Allergic conditions: Bronchial asthma, urticaria ā¢ Parasitic infections: Ascariasis, filariasis, ā¢ Pulmonary eosinophilia ā¢ Addisonās disease ā¢ Langerhanās cell histiocytoses Eosionopenia: ā¢ Cushingās syndrome ā¢ Aplastic Anemia ā¢ Steroid therapy Eosinophils from a case of Hypereosinophilic syndrome
- 18. Hypereosinophlic syndrome ā¢ Persistent elevation of the eosinophil count (>1.5x109 ) of uncertain cause for more than 6 months. ā¢ Treatment initially with steroids and then with cytotoxic drugs if these fail.
- 19. Basophils ā¢ Size ā¢ Nucleus : 8-10 Āµ diameter : bilobed, Sshaped lenty, ā¢ Cytoplasm : basophilic,granular ā¢ Granules : coarse, purple/ blue,p Secrete: ā Histamine ā Tryptase ā Esoniphil chemotactic factor of anaphylaxis (ECF-A) ā¢ Life span : 12-15days
- 20. ā¢ Functions : - produce hypersensitivity reaction like allergy and anaphylaxsis -- mild phagocytosis Basophilia Chicken pox Small pox Polycythemia Iron deficiency Chronicmyeloid leukemia Basopenia ā¢Steroid therapy ā¢Cushingās syndrome ā¢Hyperthyroidism
- 21. Monocytes : 14- 18 Āµ diameter (largest) : pale , round/kidney shaped ā¢ Size ā¢ Nucleus ā¢ Cytoplasm : termed agranular but fine pale blue granules are present ā¢ Life span : 48-72 hrs in blood & 3 months in tissues. Functions : -2nd line of defense -Are phagocytic -Secrete IL-1 MONOCYTES
- 22. Monocytopenia: ā¢ Aplastic anemia ā¢ Septicemia Monocystosis: ā¢ Acute monocystic leukemia ā¢ Hodgkinās disease ā¢ Malaria ā¢ Glucocorticoid therapy
- 23. Lymphocytes ā¢ Can be classiļ¬ed in two ways ā Based on size: a) large : 10-12 Āµ b) small : 7-10 Āµ ā Based on function: a) T Lymphocytes b) B Lymphocytes ā¢ Life span : Ā½-1 day Small lymphocyte Large lymphocyte
- 24. ā¢ Normal Lymphocyte count is 20 ā 40% of total leucocytes ā¢ Absolute cunt is 500 ā 800 per cu mm of blood Functionally lymphocytes are divided into: ā¢ B cells: mediate humoral or antibody mediated immunity ā¢ T cells: mediate cellular or cell mediated immunity ā¢ NK cells: mediate natural and nonspecific immunity
- 25. ā¢ Small Lymphocytes: ā¢ Constitute- 20 ā 50% of total lymphocytes ā¢ Cell are 6 ā 9 um in diameter ā¢ Nucleus: Ovoid or Kidney shaped ā¢ Large Lymphocytes: ā¢ Constitute: 50 ā 80% of total lymphocytes ā¢ Size: 10 ā 15 um in diameter ā¢ Nucleus: Oval and eccentrically placed
- 26. Causes for Lymphocytosis: ā¢ Acute lymphocytic leukemia ā¢ Chronic lymphocytic leukemia ā¢ Infectious mononucleosis ā¢ Tuberculosis ā¢ Postsplenectomy Lymphocytopenia: ā¢ AIDS ā¢ Aplastic anemia ā¢ Hepatitis ā¢ Glucocorticoid therapy
- 30. Leukemia āŖ It is malignant neoplasia of hemopoetic cells in which there is abnormal proliferation of leucocytes and their precursors. āŖ Due to impaired differentiation, regulation and programmed cell death āŖ Immature WBCs in the circulating blood āŖ Increased susceptibility to infection & bleeding
- 31. Classiļ¬cation: ā¢ Based on clinical behaviour: Acute/ Chronic ā¢ Based on primary hematopoietic cell line: Myeloid /Lymphoid Four principal diagnostic categories: ā¢ Acute myelogenous leukemia ā¢ Acute lymphocytic leukemia ā¢ Chronic myelogenous leukemia ā¢ Chronic lymphocytic leukemia
- 32. WHOclassiļ¬cation of Acute Leukemia 69
- 33. AcuteLeukemia ā¢ There is a failure of cell maturation in acute leukemia. ā¢ Proliferation of cells which do not mature leads to an accumulation of primitive cells which take up more and more marrow space at the expense of normal haematopoietic elements. ā¢ Acute lymphoblastic leukemia (ALL) is 4 time more common in children than in adults. ā¢ Clinical features are similar to those of bone marrow failure.
- 34. Chronic Leukemia ā¢ Chronic myeloid leukemia accounts for 20% of all cases. ā¢ Between 30 ā 60 years of age ā¢ Outstanding physical sign : ā¢ CML- splenomegaly, lymphadenopathy (rare) ā¢ Marked elevation of leucocyte count ā¢ CLL- Lymphadenopathy, splenomagaly (rare) ā¢ Mild
- 36. ClinicalFeatures ā¢ Anaemia ā weakness and lethargy ā¢ Leucopenia ā infections ā¢ Thrombocytopenia ā purpura and bleeding ā¢ Bone and joint pain may occur ā¢ Lymphadenoapthy and hepatosplenomegaly are frequent ā¢ CNS presentation is rare at though common at late stages of the disease.
- 37. Management ā Remission Induction: Last for 28 days 3-4 Drugs( Vincristine, Prednisone, L-asparaginase) ā CNS Preventive therapy/Prophylaxis CNS ā site for leukemic inļ¬ltrates Chemotherapeutic Drugs ā Cross BBB Intrathecal injection - Methotrexate ā Maintenance Suppress leukemic growth- Cont. admin Methotrexate & 6- mercaptopurine
- 38. Summary ā¢ WAYS TO MAINTAIN YOUR WBCāS: ā¢ Avoid sugar and keep sweet stuff to a minimum. Sugar prevents white blood cells from being their strongest ā¢ Eliminate unhealthy fats. Polyunsaturated fats in vegetable oils such as corn, safflower, and sunflower oil are deterrents to a healthy immune system . ā¢ Drink plenty of water to boost the immune system as well as flush out. ā¢ Avoid stress and try to relax. Stress is rightly called the silent killer and too much stress invariably leads to a lowered immune system.
- 39. ā¢ Leukemoid reaction ā¢ A leukemoid reaction is an increase in the white blood cell count, which can mimic leukemia. The reaction is actually due to an infection or another disease and is not a sign of cancer. ā¢ Blood counts often return to normal when the underlying condition is treated. ā¢ Tuberculosis ā¢ Infectious mononucleosis
- 40. ā¢ In aleukemic leukemia, increased number of white blood cells is not detected in a blood test. ā¢ It is a rare type of leukemia. This type of leukemia can also be lymphocytic, monocytic, or myelogenous.
- 41. ā¢ Hairy cell leukemia is a rare, slow-growing cancer of the blood in which your bone marrow makes too many B cells (lymphocytes). ā¢ These excess B cells are abnormal and look "hairy" under a microscope. As the number of leukemia cells increases, fewer healthy white blood cells, red blood cells and platelets are produced. ā¢ Hairy cell leukemia affects more men than women, and it occurs most commonly in middle- aged or older adults.
- 42. ā¢ Etiology of leukemia: ā¢ Involves a combination of genetic and environmental factors. ā¢ Leukemia cells acquire mutations in their DNA that cause them to grow abnormally and lose functions of typical white blood cells. ā¢ One type of change in the cells' DNA that is common in leukemias is known as a chromosome translocation. In this process, a portion of one chromosome breaks off and attaches to a different chromosome. ā¢ Translocation seen in almost all cases of CML and in sometimes in other types of leukemia is an exchange of DNA between chromosomes 9 and 22, which leads to what is known as the Philadelphia chromosome. This creates an oncogene (cancer-promoting gene) known as BCR-ABL.
- 43. ā¢ A condition known as Li-Fraumeni syndrome is characterized by an inherited mutation in a tumor suppressor gene known as TP53, and individuals with this condition have an increased risk of leukemia and other cancers. ā¢ Other hereditary conditions that can increase the risk of developing leukemia include Down syndrome, neurofibromatosis type 1, ataxia telangiectasia, and Noonan syndrome. ā¢ Exposure to radiation is known to increase the risk of developing AML, CML, or ALL. Increases in leukemia were observed in people surviving atomic bombs. Radiation therapy for cancer can also increase the risk of leukemia. ā¢ Exposure to certain chemicals, including benzene (used commonly in the chemical industry), increases the risk of leukemia. Cigarette smoking is known to increase the risk of developing AML.
- 44. ā¢ Blood disorders known as myelodysplastic syndromes confer an increased risk of developing AML. ā¢ Human T-cell leukemia virus type 1 (HTLV-1) is a virus that causes a rare type of leukemia. ā¢ Certain chemotherapy drugs for cancer can increase the risk for AML or ALL.
- 45. Lazy leukocyte syndrome ā¢ Characterized by ā¢ recurrent infections, ā¢ stomatitis, ā¢ a low neutrophil count, and ā¢ impaired neutrophil motility,2-5 a ā¢ Etiology: mutations in actin-interacting protein 1 (Aip1) ā¢ Lazy leukocyte syndrome is a severe neutropenia with associated abnormal neutrophil motility. ā¢ The marked increase in neutrophil actin filament content, failure of these cells to form a normal polar structures with lamellipodia at the front, and the marked slowing of cell motility in response to chemoattractants.
- 46. ā¢ Mechanisms listed below may be involved in mediating the effects of dietary fat on immune Response (IR): ā¢ Serum lipoproteins. Both the concentration and composition of dietary fat (fatty acids as well cholesterol) can alter serum lipoprotein profile, which influences the activity of the immune cells. ā¢ Low-density lipoproteins (LDL) inhibited lymphocyte and neutrophil functions, while high-density lipoproteins (HDL) enhanced neutrophil chemotaxis and phagocytosis. ā¢ One of the mechanisms by which LDL inhibits lymphocyte and monocyte functions is through apolipo proteins B and E (apo B and E).
- 47. ā¢ The primary issue with Poly Unsaturated Fatty Acids is that they are highly unstable. ā¢ All fats have a temperature with which they oxidize (i.e. become unstable, go rancid, become toxic). ā¢ For PUFAs that temperature is very low. An easy way to remember this is that UNsaturated fats are UNstable and Saturated fats are Stable. ā¢ Unstable fats are prone to oxidation. Oxidation lead to free radicals. ā¢ Free radicals lead to cellular damage in body that can manifest both internally in the form of damaged organs/glands and externally in the form of rapidly aging skin. ā¢ During processing, many of these "seed" oils are exposed to high heat (imagine trying to extract oil from a grape seed), which can often make the oils unstable. In addition, these oils may be exposed to high heat during travel which can also lead to a damaged and unstable product.
- 48. Classiļ¬cation ALL can be classiļ¬ed into 3 types on morphological criteria (FAB classiļ¬cation) L1: most cells are small with little cytoplasm and indistinct nucleoli. L2: cells tend to be larger with relatively more cytoplasm. Nuclei often clefted with prominent nucleoli. L3: large blasts with very blue cytoplasm with prominent vacuoles. These blasts are like found in Burkittās lymphoma.
- 49. Thank You ļ