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White blood cells.

Normal and malignant.

Simplify FBC testing. Instruments are essentially particle counters with additional test to determine type of cells.
What are scatterplots? A graphical representation of electronic data generated by the laser/cell interaction.
What does each coloured area (and dotted area) on a scattergram represent? A reportable parameter (the dotted regions indicate flagging areas).
What are automated WBC differential and blood films useful for? Evidence of and response to infection. Allergic response. Leukemia. Marrow infiltration.
What can flow cytometry show? Lymphoid and myeloid populations and degree of cell maturity.
What is cytogenetics? Metaphase analysis and flourescent in-situ hybridisation.
Why would gene sequencing be used? To look for specific mutations.
Why would a bone marrow examination be used? To assess the number and type of normal and abnormal cells.
What happens to bone marrow with age? At birth marrow is widely distributed, retreating to axial skeleton by adulthood.
What happens to embryonic stem cells? Embryological stem cells form "blood islands" in the yolk sac. Cells migrate to liver then spleen then marrow in foetus.
What is the stroma of bone marrow composed of? Fibroblast-like reticular cells, collagenous fibres and extracellular matrix.
What is the commonest of the WBCs? Neutrophils (50-70% of the total).
What is the lifespan of neutrophils? 8-10 hours.
What is chemotaxis? When neutrophils migrate in response to e.g. bacterial wall antigens.
How do neutrophils contrast with lymphocytes? They do not recognise specific antigens.
How do neutrophils deal with bacteria? Bacteria are ingested and killed by enzymes in granules e.g. lysozyme, peroxidase.
When to neutrophil numbers change? Rise as acute response to bacterial infection, inflammation and malignancy.
What are the three types of Granulocytes? Basophils, Eosinophils and Neutrophils.
How much of the total blood WBC do eosinophils make up? 1-6%.
What colours does eosin stain the granules? Orange/pink.
What is the lifespan of eosinophils? 4-5 hours (longer in tissues).
What promotes the growth of eosinophils? Interleukin-5.
What is contained in the eosinophil granules? Major basic protein and reactive O2 species.
What do eosinophils respond to? Helminth infection. Chemokines attract them to specific tissues.
Where are eosinophils commonly found? Commonly seen in atopy e.g. eczema, asthma and hayfever.
What is a basophil an example of? A granulocyte.
What proportion of the total blood WBCs do basophils make up? <1%.
What do dark basophilic granules contain? Histamine, leukotrienes, proteases and heparin.
What are the roles of basophils? Phagocytosis and in hypersensitivity (allergic) reaction.
What is the cell surface receptor on a basophil for? Cell surface receptor for IgE-binding produces degranulation following chemotaxis.
What is anaphylaxis? A type 1 allergic reaction.
What proportion of blood WBCs do lymphocytes make up? 20-40%.
How can we subdivide lymphocytes? They differentiate early from other marrow derived cells. Divide into T (thymus) and B (bone marrow or bursa).
What increases the lifespan of a lymphocyte? Much longer life span in blood/marrow and lymph node.
What can T and B cell malignancies cause? Leukemia.
What proportion of circulating blood cells do monocytes/macrophages make up? 5-10%.
What do macrophage granules contain? Hydrolases and myeloperoxidase.
How long do macrophages circulate for? 8-12 hours but much longer in tissues.
What are the roles of monocytes? Ingest material and present peptides to T cells. To kill mycobacteria and fungi and intracellular organisms e.g. listeria.
What are the differences between chronic and acute myeloid leukemia? Pace of disease, presentation, molecular mechanism, method of treatment and outcome.
What age groups does chronic myeloid leukemia occur? Occurs in all age groups.
What are the symptoms of chronic myeloid leukemia? Anaemia, large spleen and bone pain.
What proportion of chronic myeloid leukemia cases have an identical cytogenetic and molecular mutation? 95%.
What are signs of chronic myeloid leukemia? Anaemia, high WBC and platelet count.
What is Imatinib? Cytotoxic drug that works by inhibiting tyrosine kinase (enzymes that are present in some cancer cells).
What increases the chances of acute myeloid leukemia? More common with increasing age.
When do symptoms of acute myeloid leukemia present? Presents with symptoms of marrow failure.
What are some signs of acute myeloid leukemia? Anaemia, Bleeding (purpura and bruises) and infections (sepsis and pneumonia).
What is a purpura? A skin rash resulting from bleeding into the skin from small blood vessels (capillaries).
Why may chemotherapy not be the best treatment for acute myeloid leukemia? Diverse cytogenetic changes so no single target for chemotherapy.
When can chemotherapy be used to treat acute myeloid leukemia? To produce marrow aplasia. Marrow then regenerates from residual stem cells.
Define aplasia. Total or partial failure of development of an organ or tissue.
How can a transplant be used to treat acute myeloid leukemia? Peripheral blood or marrow derived stem cells as transplant for selected patients- toxic but effective.
What are the problems of using chemotherapy to treat acute myeloid leukemia? Infections (neutropenia), bleeding (thrombocytopenia), psychological (long periods in hospital and uncertainty) and venous access (peripheral/central lines).
Created by: robertspedding