Transcript Nrsg 407 Disorders of Blood Cells x

DISORDERS OF BLOOD
CELLS & VESSELS
CHAPTER 7
HEMATOPOIESIS
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Generation of blood cells
Lymphoid progenitor cells = lymphocytes (WBCs)
Myeloid progenitor cells = all other blood cells
Red blood cells transport oxygen
• Hemoglobin is the compound in RBCs to which oxygen
attaches for transport from lungs to tissues
• Synthesis depends on iron, vitamin B12, vitamin B6, & folic acid
WHITE BLOOD CELLS ACTIVE IN
IMMUNITY AND INFLAMMATION
• Hormones and inflammatory and immune molecule
mediators stimulate production of WBCs & platelets
• Leukocytes fight microbes & other invaders
• Promote the repair process
LIFE SPAN OF BLOOD CELLS
Varies, shorter life span than other tissues
Rapid cell turnover
RBCs have longest life out of blood cells
Disease of blood cells are d/t early cell death or
destruction
• The number of WBCs, RBCs, & platelets in blood is a
function of their life span and the rate of their
production versus the rate of their loss
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ANEMIA
• Low hemoglobin in blood
• Always a sign of some underlying condition
• Diagnosis:
• CBC
• Look at RBCs for either:
• Failed Bone marrow production
• Hemorrhage or destruction
• Treatment:
• Replace RBCs
• Identify cause and reverse it
SICKLE CELL DISEASE
• Autosomal recessive genetic disorder of
hemoglobin synthesis
• Hemoglobin is molecularly defective and unstable
• Causing early RBC death
• Clinical and Pathologic findings:
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Obstruction of small blood vessels
Anemia
Hemolysis
Infections
WHITE BLOOD CELL MALIGNANCIES
• Myeloid malignancies
• Myeloid cells-precursors of granulocytes, RBCs, and
megakaryocytes
• Examples: Acute or chronic myeloid leukemia
• Lymphoid malignancies
• Lymphoid cells: B,T, or natural killer lymphocytes
• Example: Acute or Chronic lymphoid leukemia
ACUTE MYELOID LEUKEMIA (AML)
• AML: Increased numerous of myeloblasts in bone
marrow and blood
• Occurs in all ages, common in adults over 50 years
• Sudden onset, symptoms appear rapidly as bone marrow
becomes packed with malignant cells
• Symptoms: bone pain, lymphadenopathy, enlarged spleen &
liver, neurologic defects
• Diagnosis: >20% of bone marrow cells must be myeloblasts
• Treatment: Chemotherapy,
CHRONIC MYELOID LEUKEMIA (CML)
• Slow, progressive disease
• Rare in children
• Moves through 3 phases:
• Indolent period
• Accelerated phase-resistant to treatment, increase anemia
and thrombocytopenia
• Evolution into AML-infection and hemorrhage dangerous
threats
ACUTE LYMPHOID LEUKEMIA (ALL)
• Malignant proliferation of immature lymphocyte
precursors
• Usually B cells
• Most common malignancy of children
• Clinically same as AML
CHRONIC LYMPHOID LEUKEMIA (CLL)
• Slow onset
• Most patients asymptomatic, disease uncovered
due to presence of another condition
• Constitutional S/S:
• Malaise, loss of appetite
• Mild fever
• Weight loss