1. 백혈구 구조, 기능 및 백혈구질환

2. 백혈구 종류 Granulocyte : neutrophil, eosinoiphil, basophil
Monocyte *mactophage
histiocyte = tissue macrophage
Lymphocyte *plasma cell

3. Differentiation of Myeloid Cells
Pleuripotent stem cell (PST)
→ CFU-GEMM → CFU-GM → CFU-G →
Myeloblast → promyelocyte → myelocyte → metamyelocyte
→ band neutophil → segmented neutrophil
(eosinophil, basophil)

4. Myeloid Pools (compartments)
Bone marrow :
Stem cell pool: PSC – CFU-G
Mitotic pool (5 ds ): myeloblast-myelocyte
Post mitotic (reserve) pool (6.6 ds):
metamyelocyte - seg.N
Peripheral blood (9.5 hrs) :
Circulating pool
Marginated pool
Tissue

5. 과립구(중성구) 구조
Primary granules: myeloperoxidase, lactoferrin, leukocyte adhesion receptors, ALP, defensin, azurophil-derived bactericidal factor (ADBF)
Secondary granules: lysozyme, collagenase, plasmin activator
Tertiary granules : adhesion molecules, gelatinase, C3b receptor
Surface membrane: CD11/CD18 complex, receptors for opsonin, chemotaxin, GM-CSF, G-CSF, phospholipid(PGE2, leukotriene, etc)
Cytoplasm: actin, myosin, tubulin

6. 중성구 살균 기능 - 관여물질
Adhesion Cascade

7. Phagocytosis and Killing

8. 과립구 기능 이상 Defects of chemotaxis : aspirin, alcohol, corticosteroids,
leukemias, lazy leucocyte syndrome
Defects of phagocytosis:
lack of opsonization (hypogammaglobulinemia)
Defects of killing:
chronic granulomatous disease (cytochrome b558 def),
myeloperoxidase def.

9. 백혈구 수(/mL) 변화 Neutrophilia : >7,500 Neutropenia : <1,500
Severe neutropenia : <500
Agranulocytosis : <100
Eosinophilia : 직접계산 ; 350 이상,
백혈구 백분율로 환산 ; 500이상
Basophilia : 이상
Monocytosis : 1,000 이상
Lymphocytosis : 성인 4,000 이상, 소아 8,800 이상

10. Neutrophilia Infection Toxins: metabolic (uremia), drugs, chemicals
Tissue destruction or necrosis: trauma, burns, myositis,
vaculitis, infarction, neoplasia
Metabolic disorder : uremia, eclampsia
Hemorrhage, especially into a body cavity
Rapid hemolysis
Hematologic disorders:
leukemias, myeloproliferative neoplasm
Pseudoneutrophilia : physical stress, drugs

11. Leukemoid reaction
WBC>50,000, or immature cells in PB
Granulocyte, Lymphocyte
Severe inflammation or infection
Leukoerythroblastic reaction
Immature granulocyte and erythroblast in PB
Myelofibrosis, BM metastastic tumor,
Massive bleeding or hemolysis,

12. 과립구의 유전성질환 Pelger-Huet anomaly May-Hegglin anomaly ; Dohle body
Chediak Higashi syndrome
Chronic granulomatous disease (CGD)
Myeloperoxidase deficiency

13. 과립구의 후천성이상 Toxic granules & vacuoles Dohle body Hypersegmentation &
Macrocytic neutrophil

14. 중성구감소증 Neutropenia Diseases that decrease neutrophil production (생산감소)
Aplastic anemia
Toxins that damage marrow
Collagen vascular diseases (such as SLE)
Myelphthisic marrow processes such as marrow infiltration by infections or metastatic carcinomas)
Hematologic malignancies such as leukemias
Myeloproliferative disorders
Radiation therapy, Chemotherapy
Congenital disorders
Diseases that increase neutrophil destruction (파괴증가)
Splenomegaly with hypersplenism
Infection
Immune destruction
Pseudoneutropenia

15. 과립구의 악성질환 Acute myeloid leukemia (AML) and related neoplasms
Myelodysplastic syndromes (MDS)
Myeloproliferative neoplasms (MPN)
Myelodysplastic–myeloproliferative neoplasms (MDS/MPN) 
Myeloid/lymphoid neoplasms
             associated with eosinophilia and abnormalities of
PDGFRA, PDGFRB, or FGFR1