Vinnytsya National Pirogov Memorial Medical University Pathophysiology Department PATHOLOGY OF WHITE BLOOD PhD., Viktoriya Piliponova

By morphology of nucleus leukocytes are divided into: polymorphonuclear; mononuclear. By the inclusions presence leukocytes are divided into: granulocyte; agranulocyte. After their origin leukocytes are divided into: myeloid; lymphoid. In vessels leukocytes form 2 pools: circulatory pool (50%); parietal (marginal) pool (50%).  

Granulocytes Agranulocytes Quantity of leukocytes in norm is equal to 4-9x109 /l. Leukogram Granulocytes Agranulocytes Eosinophils Basophils Neutrophils Lymphocytes Monocytes 1-5% 0-1% meta-myelosytes: 0-1%, Bands (stab): 1-6%, Segm: 47-72% 19-37% 3-11%

White blood pathology Types of violations: leukocytosis; leukopenia; leukemia. LEUKOCYTOSIS is the increase of leukocytes quantity in the unit of the blood volume over than 9 x 109/l.

physiological; pathological. emotional; alimentary; myogenic; static; CLASSIFICATIONS OF LEUKOCYTOSIS By pathogenesis leukocytosis are divided into: physiological; pathological. Kinds of physiological leukocytosis: emotional; alimentary; myogenic; static; in pregnant; in new-born.

Kinds of pathological leukocytosis: increase of leukopoiesis enlarged exit of leukocytes from the marrow redistributional hemoconcentrational.

Classification of leukocytosis according to mechanism: Absolute - enlarged production or acceleration of leukocytes entrance from the marrow into the blood. Relative - as a result of leukocytes redistribution or hemoconcentration.

Classification of leukocytosis after cellular composition: neutrophilic [neutrophilia]; eosinophilic [eosinophilia]; basophylic [basophilia]; lymphocytic [lymphocytosis]; monocytic [monocytosis].

Neutrophilic leukocytosis Reasons: purulent inflammation aseptic inflammation.

nuclear shift Neutrophils myelosytes: 0%, meta-myelosytes: 0-1%, bands (stab): 1-6%, Segmented: 47-72% nuclear shift

Types the nuclear shift to the left: regenerative hyperregenerative regenerative-degenerative degenerative

Eosinophilic leukocytosis Reasons: allergic reactions helminthic invasions adrenal cortex insufficiency chronic myeloleukemia

Basophylic leukocytosis Reasons: allergic reactions, autoimmune diseases; chronic myeloleukemia myxedema; hemophilia; tumors.

Lymphocytic leukocytosis Reasons: chronic specific infection diseases acute infection diseases chronic lymphocytic leukemia; lymphomas

Monocytic leukocytosis Reasons: chronic specific infection diseases; acute infection diseases Malaria; ricketsiosis; chronic monocytic leukemia; infectious mononucleosis; ovarian carcinoma and breast cancer; agranulocytosis (in the recovery stage).

LEUKOPENIA is decrease of leukocytes quantity in the unit of blood volume less than 4 x 109/l.

Classification of leukopenia by their origin: Primary (inherited) Kosthman’s neutropenia; periodic (cyclic) leukopenia Secondary (acquired)emerges as a result of action: radiation ionizing; chemical agents (some drugs, benzol); biological agents (viruses, bacteria, fungi).

Classification of leukopenia by their pathogenesis: Inhibition of leukopoiesis Diminishing of leukocytes coming out from the marrow Increase of destruction of leukocytes

AGRANULOCYTOSIS is the decrease or absence of granulocytes less than 0,75 x 109/l by the decrease of leukocytes quantity less than 1 x 109/l.

LEUKEMIA is the systemic blood disease of tumor nature with the obligatory primary affection of the marrow which is characterized by a hyperplasia, metaplasia and anaplasia of the hematopoietis tissue.

Etiology Carcinogenic factors : physical chemical biological hereditary

Classification of leukemias acute chronic myeloid; lymphoid; undifferentiated.

Pathogenesis 1-monoclonal stage 2-polyclonal stage– Terminal

ACUTE LEUKEMIA Gemogram: blasts quantity is more than 30%; “leukemic gap” anemia; trombocytopenia.

CHRONIC LEUKEMIA Gemogram: blasts quantity less than 5%; plenty of maturing cells of the 5th level insufficient quantity of mature cells of the 6th class anaemia; trombocytopenia.

ERYTHREMIA Vaquez-Osler disease (polycythemia) is chronic leukemia, which is characterized by the marrow injury at the myeloid progenitor cell level with unlimited proliferation which keeps a capacity for differentiation after four tissues, but in the first place by the red ones.   Difference between erythremia and erythrocytosis: at erythremia the all blood cells quantity (red corpuscles, thrombocytes, leukocytes) increases in erythrocytosis – only erythrocytes quantity increases.

Leukaemoid reactions – reactions from the blood side which morphologically are close to leukemia but differ from leukemia by etiology and pathogenesis and does not turn into leukemia on which they alike.

After the blood picture leukaemoid reactions are divided into: myeloid type: neutrophilic; eosinophilic; lymphoid type; lymphoid; monocytic; mixed.

Principles of treatment: Cytostatic drugs Principles of treatment: