6. White Cells Flashcards
Neutrophils
granules
Polymorphonuclear
Lifespan in blood about 10 hours
Neutrophil Leucocytosis
Bacterial infections
Inflammation and tissue necrosis e.g. trauma, myocardial infarct
Malignancies of all types
Acute haemorrhage
Steroid treatment
Myeloproliferative disease
Neutropenia
abnormally low conc of neutrophils in blood
Congenital (rare)
Acquired
Drug-induced
Cyclical Immune Infections
Part of General Pancytopenia Bone marrow failure
Lymphocytosis
an increase in the number of lymphocytes in the blood.
Infections Acute: infectious mononucleosis, rubella, pertussis, mumps, cytomegalovirus Chronic: TB, toxoplasmosis, brucellosis Leukaemia Lymphoma
Lymphopenia
abnormally low level of lymphocytes in the blood
Congenital immune deficiencies Acquired immune deficiency syndrome Bone marrow failure Steroids and other immunosuppressive therapies Hodgkin’s disease
Leukaemia
Accumulation of abnormal wbcs in the bone marrow
bone marrow failure
Acute Leukaemia
Derived from abnormal stem cell
Blasts unable to differentiate normally
Accumulation of myeloblasts
crowds out normal marrow
Life threatening
Clinical features of Acute Leukaemia
•Due to Bone Marrow failure
Anaemia: Pallor, lethargy, dyspnoea
Neutropenia: Infections of mouth, throat, skin, chest, perianal region
Thrombocytopenia: Spontaneous bruising, bleeding gums, nose bleeds, menorrhagia
•Due to organ infiltration
Bone pain
Lymphadenopathy
Hepatosplenomegaly
Investigations
Full blood count
Coagulation screen
Biochemistry
Chest X-ray
Bone marrow
Management of Acute Leukaemia
Immediate referral
Neutropenia: Broad spectrum antibiotics
Thrombocytopenia: Platelet transfusion
Anaemia: Blood transfusion
chemotherapy
Bone marrow transplant
Chronic Myeloid Leukaemia (CML)
Leukaemic cells differentiate into mature forms (cf. acute leukaemia)
Treatment of CML
New agents that block product of Philadelphia chromosome (BCR-ABL)
‘Tyrosine Kinase Inhibitors’ May eradicate Philadelphia chromosome
Chronic Lymphocytic Leukaemia (CLL)
Commonest leukaemia (37% of all leukaemias) 3200 new cases in the UK in 2012 Incidence increases with age (43% >75 yrs) Accumulation of lymphocytes in blood, marrow, spleen and lymph nodes Often diagnosed incidentally Survival of early disease >14 years Incurable May not need treatment
Lymphoma
Malignant
5th most common cancer in UK
Treatment of Lymphoma
Watch and wait
Chemotherapy
Radiotherapy
Monoclonal antibodies
Stem cell transplantation
