Hong Kong Metropolitan University MLS 1004SEF Haematology & Transfusion Science PDF

HONG KONG METROPOLITAN UNIVERSITY MLS 1004SEF Haematology & Transfusion Science H.LEE Basic Haematology 1-2-2024 1/2/2024 Basic Haematology 1 Functions of the Hematology Laboratory Confirm a physician’s clinical impression of a possible hematological disorder - Establish a diagnosis or rule out a di...

HONG KONG METROPOLITAN UNIVERSITY MLS 1004SEF Haematology & Transfusion Science H.LEE Basic Haematology 1-2-2024 1/2/2024 Basic Haematology 1 Functions of the Hematology Laboratory Confirm a physician’s clinical impression of a possible hematological disorder - Establish a diagnosis or rule out a diagnosis - Detect an unsuspected disorder - Monitor the effects of radiation or chemotherapy - 1/2/2024 Basic Haematology 2 Basic Haematology 1/2/2024 Basic Haematology 3 Basic Haematology Haematology – Study of formed cellular blood elements: the white blood cells, red blood cells and platelets Hemostasis – Arrest of bleeding by the formation of a barrier to blood loss – Maintenance of an adequate number of cells to carry out the functions Haematopoiesis – Dynamic formation and development of blood cells, normally in the bone marrow – Process responsible for the replacement of circulating blood cells 1/2/2024 Basic Haematology 4 Basic Haematology Haematology is the study of formed cellular blood elements: 1. White blood cells (WBC) 2. Red blood cells (RBC) and 3. Platelets 1/2/2024 Basic Haematology 5 Components of blood Plasma (55%) – involved as transport medium for nutrients and metabolites; involved in immune defense and coagulation Erythrocytes (RBCs) (43%) -Contain haemoglobin and function in the transport of O2 and CO2 Leukocytes (WBCs 1%) - involved in the body’s defence against the invasion of foreign antigens. Platelets (thrombocytes 1%) - involved in haemostasis which forms a barrier to limit blood loss at an injured site. 1/2/2024 Basic Haematology 6 Plasma Components Plasma 2.7-3L in an average human male (5L of blood per average human) Composition: 92% water, 8% blood plasma proteins including: albumins, globulins, fibrinogen, electrolytes(Na ,Cl), enzymes, hormones, enzymes, nutrients, and respiratory gases 1/2/2024 Basic Haematology 7 Function of Plasma 1. Maintaining proper blood osmotic pressure, which is important in total body fluid balance 2. Transporting nutrients and metabolites within the system. For example, hormones made in one tissue are transported by the plasma to target tissues in other parts of the body. 3. Immune defense. Immunoglobulins and complement also help in the immune defense. 4. Coagulation Plasma also serves as a reservoir for proteins that circulate in the blood as inactive enzymes. These enzymes stay inactive until an injury occurs initiating the coagulation process. 1/2/2024 Basic Haematology 8 Leukocyte WBC Function – Protect the host from infectious agents or pathogens Innate/Nonspecific – Natural Immune response – 1st response to pathogens (nonself) – Neutrophils, monocytes, and macrophage main players Adaptive Immune response/Specific – – – – 1/2/2024 Starts in lymphoid tissue Slow Long-lasting immunity (memory) Lymphocytes become “activated” Basic Haematology 9 Leukocyte WBC - heterogeneous group of nucleated cells that are responsible for the body’s defenses - WBCs are present in normal blood in smaller number than the red blood cells (4.0-11.0 × 103/µl in adults). - Their production is in the bone marrow and lymphoid tissues (lymph nodes, lymph nodules and spleen). 1/2/2024 Basic Haematology 10 Leukocyte WBC There are five distinct cell types each with a characteristic morphologic appearance and specific physiologic role. These are: 1. Polymorphonuclear leucocytes/granulocytes - Neutrophils - Eosinophils - Basophiles 2. Mononuclear leucocytes - Lymphocytes - Monocytes 1/2/2024 Basic Haematology 11 Leukocyte WBC 1/2/2024 Basic Haematology 12 Leukocyte WBC 1/2/2024 Basic Haematology 13 Leukocyte WBC 1/2/2024 Basic Haematology 14 Leukocyte WBC Polymorphonuclear Leucocytes have a single nucleus with a number of lobes. They contain small granules in their cytoplasm, and hence the name granulocytes. There are three types according to their staining reactions. Neutrophils 10-12µm in diameter. capable of amoeboid movement. 2-5 lobes to their nucleus that stain purple violet. The cytoplasm stains light pink with pinkish dust like granules. Their number increases in acute bacterial infections. Normal range: 2.0-7.5 x 103 /µl. 1/2/2024 Basic Haematology 15 Leukocyte WBC Eosinophils - same size as neutrophils or may be a bit larger (1214µm). - two lobes to their nucleus in a "spectacle" arrangement. - nucleus stains a little paler than that of neutrophils. - Eosinophils cytoplasm contains many, large, round/oval orange pink granules. - Increase in their number (eosinophilia) is associated with allergic reactions and in combating helminthic infections. - Normal range: 40-400/ µl. 1/2/2024 Basic Haematology 16 Leukocyte WBC - Basophils size ranges from 10-12µm in diameter. kidney shaped nucleus frequently obscured by a mass of large deep purple/blue staining granules. Their cytoplasmic granules contain heparin and histamine that are released at the site of inflammation. Basophilia is rare except in cases of chronic myeloid leukemia. Normal range: 20-200/µl. 1/2/2024 Basic Haematology 17 Leukocyte WBC Monocytes - the largest white cells measuring 14-18µm in diameter. - They have a centrally placed, large and ‘horseshoe’ shaped nucleus that stains pale violet. - Their cytoplasm stains pale grayish blue and contains reddish blue dust-like granules and a few clear vacuoles. - They are capable of ingesting bacteria and particulate matter and act as "scavenger cells" at the site of infection. Monocytosis is seen in bacterial infections. (e.g. tuberculosis) and protozoan infections. - Normal range: 700-1500/µl. 1/2/2024 Basic Haematology 18 Macrophage Once the monocyte enters the tissues, it becomes a macrophage – Size:15-80µm – Cytoplasm Gray-blue and abundant Ragged edges Vacuoles common – Nucleus Round with netlike appearance Purplish with finer clumped chromatin Nucleoli appear 1/2/2024 Basic Haematology 19 Leukocyte Common lymphoid progenitor cell (CLP) gives rise to the committed precursor cells: - T lymphocytes (60-80% of lymph population) (Thymus) - B lymphocytes (10-20%) (Bone marrow) - Natural killer cells (NK) (~ 2 %) (Bone marrow or thymus) 1/2/2024 Basic Haematology 20 Leukocyte Reference range= 1.0- 4.8 x 109/L Lymphocytosis – Increase in lymphocytes – Absolute number exceeds 4.8 x 109/L Lymphocytopenia – Decrease in lymphocytes – Absolute number of lymphocytes is