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Leukocytes White Blood Cells

Formation of WBCs
Leukocytes are formed in the red marrow of many bones. They can also be formed in lymphatic tissue. They live for about 13-20 days.

Myelocytic Maturation Series

Myeloblast Promyelocyte Myelocyte Metamyelocyte Band Neutrophil Segmented Neutrophil


HSC: hemopoeitic stem cell, HPG: hemopoeitic progenitor cells, CMP: committed myeloid progenitor cell, CLP: committed lymphoid progenitor cells, CFU: colony forming unit

White Blood Cells

WBC Numbers
Doctors look at WBC numbers. If number goes up there is some kind of infection . Clinics will count the number of WBCs in a blood sample, this is called differential count. A decrease in the number of white blood cells is leukopenia. An increase in the number of white blood cells is leukocytosis.

White Blood Cells

Per l blood Total WBC count Neutrophils Lymphocytes
50 - 70% 20 - 40%

Per l of blood
5,000 10,000 2,000 7,000 1,000 4,000

Eosinophils Basophils

1 6%
1 5% 0 2%

50 600
50 500 0 - 100

Five Types Classified according to the presence or absence of granules and the staining characteristics of their cytoplasm. Leukocytes appear brightly colored in stained preparations, they have a nuclei and are generally larger in size than RBCs.

Type of WBCs

Granulocyteshave large granules in their cytoplasm

Neutrophils Eosinophils Basophils

Eosinophils Large, numerous granules Nuclei with two lobes 2-5% of WBC count Found in lining of respiratory and digestive tracts Important functions involve protections against infections caused by parasitic worms and involvement in allergic reactions Secrete anti-inflammatory substances in allergic reactions

Least numerous--.5-1% DiapedesisCan leave blood vessels and enter tissue space Contain histamineinflammatory chemical

Neutrophils Stain light purple with neutral dyes Granules are small and numerous course appearance Several lobes in nucleus 65% of WBC count Highly mobile/very active DiapedesisCan leave blood vessels and enter tissue space Phagocytosis (eater), contain several lysosomes

Types of WBCs
Agranulocytesdo not have granules in their cytoplasm
Lymphocytes Monocytes

Lymphocytes Smallest WBC Large nuclei/small amount of cytoplasm Account for 25% of WBC count Two typesT lymphocytesattack an infect or cancerous cell, B lymphocytesproduce antibodies against specific antigens (foreign body)

Largest of WBCs Dark kidney bean shaped nuclei Highly phagocytic

White blood cells disorders

I. Leukocytosis

increased number of leucocytic count above upper range of normal(11,000/mm3 in adult).


1. 2. 3. 4. 5.

Neutrophils > 7.5 x 109/L

Acute pyogenic infection Tissue damage: Truma or infarction Malignancy Myeloproliferative disorders : CML Drugs: digitalis, Cortison. Myeloproliferative disorders (CML)


Eosinphils > 4 x109/L ( 0.04- 0.4 X109/L). Causes:

1. 2. 3. 4. 5.

Allergic diseases parasitic diseases Recovery from acute infection certain skin diseases Drug sensitivity


Basophils > 0.1 x 109/L (N: o.o1-o.1x109/L). Causes: Myeloproliferative disorders (MPD)e.g. CML.

Monocytes > 0.8x 109/L (N: 0.2-0.8x109/LCauses: Causes: Chronic bacterial infection e.g. brucllosis, typhoid.

Relative Lymphocytosis: PMN leucocytes are decreased, so the lymphocytes are relatively increased.

Causes: 1. Viral infection CMV Measels 2. Bacterial infection Pertusis Brucellosis 3. Chronic lymphocytic leukemia 4. Lymphoma



Decrease in leucocytic count below 4000/mm neutropenia: <2000/mm Causes: Drugs: anti inflammatory anti bacterial anti malarial

2. Infection:
Viral: Hepatitis, HIV Bacterial: brucellosis some fungal infections

Marked reduction of neutrophils below 500/mm.

1. 2. Lymphocytes <1500/mm Causes: Irradiation Steroids and Immunosuppressive drugs

Infectious Mononucleosis
Caused by EBV Clinical picture: sore throat, fever, Lymphadenopathy splenomegaly.

Laboratory findings: Absolute lymphocytosis with atypical lymphocytes.

Neoplastic Proliferation of White Cells

Leukemia Malignant neoplasm of the hematopoietic stem cells BM replaced by unregulated, proliferating, immature neoplastic cells blood leukemia enter spleen, lymph nodes

Neoplastic Proliferation of White Cells

Classification of Leukemia A. According to cell type and state of cell maturity
Lymphocytic immature lymphocytes and their progenators Myelocytic pluripotent myeloid stem cells and interferes with maturation of all granulocytes, RBC and platelets


Acute or Chronic
Acute immature cells (blast) Chronic well differentiated leukocytes

Classification of leukemias
Acute Myeloid origin
Acute Myeloid Leukemia (AML)

Chronic Myeloid Leukemia (CML)

Lymphoid origin

Acute Lymphoblastic Leukemia (ALL)

Chronic Lymphocytic Leukemia (CLL)

nave B-lymphocytes Plasma cells T-lymphocytes

Lymphoid progenitor

Hematopoietic stem cell Myeloid progenitor Neutrophils Eosinophils Basophils Monocytes Platelets

Red cells

Acute Leukemia

Acute Lymphocytic Leukemia (ALL)

Most common leukemia in children (80%) Treatable and potentially curable Classified according to lymphocytes and state of maturations


Acute Myleocytic Leukemia (AML)

Acute Non-lymphocytic Leukemia (ANLL)

Most common in adults; >50% 60years old

Acute Myeloid Leukemia

accumulation of blasts in the marrow

Auer rods in AML

Chronic Leukemia

Classification of CL.
There are two types:
1-chronic myeloid leukemia. 2-chronic lymphoid leukemia.

Chronic Myeloid Leukemia.

Definition of CML:
Is a clonal disorder of a pluripotent stem cell and is classified as one of the myeloproliferative disorder.


Chronic lymphocytic Leukemia:


Splenomegaly & hepatomegaly

CBC: Wbc: Diff:lymphocytosis Anemia:normocytic normochromic anemia Platelets : thrombocytepenia may occur.

Good Luck!..