Tabuk University

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Tabuk University

• Faculty of Applied Medical Sciences
• Department Of Medical Lab. Technology
• 2nd Year Level 4 AY 1433-1434

Hematology 1, MLT 205
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Normal Haemopoiesis

• ????? ??????? ????
• Mr. Waggas Elaas, M.Sc, MLT

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References

• For theory
• Essential Haematology, John Wiley Sons Ltd ,6th
  Edition,Victor Hoffbrand.
• Harmening, Denise. (2009) . Clinical Hematology
  and Fundamentals of Hemostasis. 5th Edition, F.
  A. Davis Company
• For practical
• Practical Haematology, Churchill Livingstone,
  Eighth edition, John V. Dacie, S. M. Lewis,
• Fischbach and Dunning. (2009). A Manual on
  Laboratory Diagnostic Tests. 8th Edition. Wolters
  Kluwer Health Lippincott Williams and Wilkins, PA
• ATLAS
• Carr and Rodak. (2008). Clinical Hematology. 3rd
  Edition, Saunders/Elsevier
• Internet site(s)
• http//www.essentialhaematology6.com/default.asp
  MCQs
• http//www.hematologyatlas.com/
• http//pathy.med.nagoya-u.ac.jp/atlas/doc/atlas.ht
  ml
• http//themedicalbiochemistrypage.org/
• http//www.bloodline.net/

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Marks

• Final Theoretical exam 40
• Final Practical exam 20 (including written
  questions)
• 1st Periodic exam 10 theory, 5 Practical
• 2nd Periodic exam 10 theory, 5 Practical
• Homework and class activities 5 Theory, 5
  Practical
• Total 100

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Objectives

1. To introduce Hematology to the students as a new
   science.
2. To identify blood components and the function of
   each.
3. To know the sites of Hemopoiesis (blood
   production).
4. To know the different stages of cell production
   of each cell linage.
5. To be able to differentiate between blood cells
   especially white cells.

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What is hematology?

• Hematology is the study of blood which is
  composed of plasma (55), and the formed elements
  which are
• The erythrocytes (RBCs) (44)
• Contain hemoglobin
• Function in the transport of O2 and CO2
• The Leukocytes (WBCs) and platelets
  (thrombocytes) (1)
• Leukocytes are involved in the bodys defense
  against the invasion of foreign antigens.
• Platelets are involved in hemeostasis which forms
  a barrier to limit blood loss at an injured site.

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Functions of blood

• 1.Transports O2 and Co2 between tissues.
• 2. Transports nutrients (Glucose, vitamins
  ..etc).
• 3. Take waste products such as lactic acid away
  from the muscles and urea from the liver to the
  kidneys.
• 4. Maintain body temperature.
• 5. Defense White blood cells.
• 6. Coagulation.

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Hematopoiesis Hemopoiesis

• Hematopoiesis is a term describing the formation
  and development of blood cells.
• Hematopoiesis in the bone marrow is called
  Medullary hematopoiesis.
• Hematopoiesis in areas other than the bone marrow
  is called Extramedullary hematopoiesis

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Sites of Haemopoiesis

• Fetus
• 0 2 months Yolk sac
• 2 7 months Liver
• 5 9 months Bone marrow
• Liver and spleen continue to produce cells until
  2 weeks after birth.
• In infancy, all the B.M is hemopoietic with
  progression to fatty tissues.
• Gradual replacement of active (red) marrow by
  inactive (fatty) tissue (50 of hemopoietic B.M
  in adults is fatty tissues)
• Expansion can occur during increased need for
  cell production

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• In adult life, hemopoietic B.M is restricted to
  central skeleton proximal ends of femurs (???
  ?????) and humeri.(??? ?????)
• Hemopoiesis can extend to long bones.
• Liver spleen can resume hemopoiesis
  Extramedullary Hemopoiesis.

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First cell Pluripotential Stem Cell (PCS)

• Appear like small Lymphocyte.
• Rare in B.M 1 in every 20 million nucleated
  cell.
• Self renewal capacity B.M
  cellularity remain constant.
• Hemopoietic progenitors When stem cells
  differentiate

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1st progenitor cell CFU-GEMM

• Colony Forming Unit Granulocyte, Erythrocyte,
  Monocyte, Megakaryocyte
• 
  stem cell (self renewal)
• Stem cell divide
• 
  Committed stem cell
• 
  
  (progenitor)
• 
  differentiation
  division

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• Stem cells are linked with Stromal cell
  (adipocyte, fibroblast, endothelial cells,
  macrophages).

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• Stromal cells secrete substances needed by stem
  cell to survive . ( collagen, fibronoectin,
  growth factors).
• Growth factors are hormones that regulate
  proliferation differentiation of cells.

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Erythropoiesis and erythrocytes

• Lifespan of Red cells 120 days
• Non nucleated
• Biconcave disc
• Production regulated by Erythropoietin
• Needs Fe, B12, folate other elements for
  development.

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• CFUe the first recognizable cell in this lineage.
  Large cell with dark blue cytoplasm, central
  nucleus and nuclei and slightly clumped
  chromatin. The cytoplasm stains paler blue as it
  loses its RNA and protein synthesis apparatus and
  nuclear chromatin becomes more condense. The
  nucleus is finally extruded from the late
  normoblast with in the marrow and reticulocyte
  are formed which still contains RNA and still can
  synthesize hemoglobin.

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• WBCs Leucocytes
• Phagocytes
  Immunocytes
• (granulocytes
  monocytes) (lymphocytes)
• Neutrophils (polymorphs)
• Eosinophils
• Basophils
• Monocytes

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• Leucopoiesis
• Myeloblast Promyelocyte
  myelocyte
• 
  Metamyelocyte
• Band/stab/juvenile
• Neutrophil
• Neutrophil

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• Monocyte
• Monoblast promonocyte
  Monocyte
• (myelomonblast)
• Macrophage
• (in tissues)

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• Lymphopoiesis
• Primary lymphoid organs (lymphocytes develop)
• Bone marrow
• Thymus
• Secondary lymphoid organs (specific immune
  responses are generated)
• Lymph nodes
• Spleen
• Lymphoid tissues
• Lymphocytes
• 
  according to size small large lymphocytes
• according to immunity T B
  lymphocytes

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• B cells mature in the bone marrow and circulate
  in the peripheral blood until they undergo
  recognition of antigen. The B-cell receptor is
  membrane-bound immunoglobulin and after
  activation this is secreted as free soluble
  immunoglobulin. At this point they mature into
  memory B cells or plasma cells
• T cells develop from cells that have migrated to
  the thymus where they differentiate into mature T
  cells during passage from the cortex to the
  medulla.

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Thrombopoiesis

• Platelets play a major role in primary
  hemostasis,
• Life span 7-10 days.
• Small discoid non nucleated.
• Produced in B.M by fragmentation of cytoplasm of
  megakaryocytes.
• Megakaryocytes undergoes endomitotic division
  DNA replication without nuclear or cytoplasmic
  division.
• One megakaryocyte gives 1000 5000 plts
• Thrombopoietin hormone (produced by liver
  kidney) is the main regulator.

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• Stem cell
• megakaryoblast
• promegakaryocyte
• 
  megakaryocyte
• 
  
• 
  platelets

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Homework-1

• 1. List the organs or systems involved in adult
  hematopoiesis. 
• 2. Describe a "pluripotent cell".
• 3. Define the following terms
•   a. erythropoiesis 
• b. granulopoiesis 
• c. lymphopoiesis 
• d. megakaryopoiesis 
• 4. Differentiate between a monocyte and a
  macrophage.
• 5. The hematopoietic stem cell is capable of
• a-Replication
• b-Differentiation
• c-Replication and differentiation
• 6. The process of hematpoiesis under the control
  of
• a- Growth hormone
• b- Hematopoietic growth factorsc
• c- Thyroid hormone