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Consists of the blood and the sites where
blood is produced
It includes the bone marrow and thereticuloendothelial system (RES)
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A specialized organ in that it exists in a fluid
state
It is composed of plasma and various types of cells
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The fluid portion of blood
Contains various proteins such as albumin,
globulin, fibrinogen, and other clottingfactors
They also contain electrolytes, waste
products and nutrientsAbout 55% of the blood volume is plasma
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RBCs (red blood cells or erythrocytes)
WBCs (white blood cells or leukocytes)
Platelets (thrombocytes)
These cellular components of blood normally
make up 40% to 45% of the blood volume
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The formation of blood or of blood cells in the
living body
Primary site: bone marrowDuring embryonic development and other
conditions: liver and spleen
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7% to 10% of the normal body weight
Amounts to 5 to 6 liters
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> The balance between clot formation and clot
dissolution or fibrinolysis
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The primary site of hematopoiesis In a child all skeletal bones are involved By adulthood marrow activity is usually limited
to the pelvis, ribs, vertebrae and sternum The adult bone marrow produces 175 billions
RBCs, 70 billion neutrophils and 175 billionplatelets each day
Under normal conditions, the marrow respondsto increased demands by releasing adequatenumber of cells in the circulation
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Makes up 4% to 5% of total body weight
It consists of:1. RedMarrow- islands of cellular
components2. Yellow Marrow- fat
Extramedullary hematopoiesis- when the liver
and spleen resumes production of blood cells
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Highly vascularWithin it are stem cells
Stem cells have the ability to replicateWhen stimulated to do so, stem cells canbegin a process of differentiation into eithermyeloid or lymphoid stem cells
Lymphoid stem cells- produce eitherT or BlymphocytesMyeloid stem cells- produce RBCs, WBCs and
platelets
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The normal RBC is a biconcave disk The RBC membrane is so thinMature RBCs consist primarily of hemoglobin RBCs have no nuclei Principal function: the transport of oxygen
between the lungs and tissues Reticulocytes- slightly immature forms of RBCsOxyhemoglobin- oxygen that binded to
hemoglobin in the lungs and that is carried inarterial blood
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Stimulated by erythropoietin , a hormone
produced by the kidney
Requires iron, vitamin B12, folic acid,pyridoxine (vitamin B6) and protein
Entire process: 5 days
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Average life span: 120 days
They are removed from the blood by the
reticuloendothelial cells particularly in theliver and spleen
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Granulocytes- granules inthe cell
Eosinophils Basophils Neutrophils
Agranulocytes(MononuclearWhite
Blood Cells) Monocytes Lymphocytes
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Production of granulocytes from the myeloid
stem cell pool
Entire process: 10 days6 hours- stays in the circulation
Function: phagocytosis- they last 1 to 2 days
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>granular fragments of giant cells in the bone
marrow, the megakaryocytes
Production: regulated by the hormonethrombopoietin
Nurtures the endothelium of blood vesselsControls bleeding
Normal Life Span: 7 to 10 days
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White blood
Most common feature: unregulated
production of WBCs in the marrowCause: not fully known, but there is some
evidence that genetic influence and viralpathogenesis may be involved
Bone marrow damage from radiationexposure or from chemicals such as benzene
and alkylating agents can cause leukemia
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Lymphoid Myeloid
Acute Chronic
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Results from the defect in the hematopoieticstem cell that differentiates into all myeloidcells: monocytes, granulocytes, erythrocytes
and platelets All age groups are affected, the risk increases
with age, with the peak incidence at 60 years AML is the most common nonlymphocytic
leukemia The prognosis is highly variableWith treatment, patients survive for less than 1
year, with death resulting from infection orhemorrhage
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Evolve from the insufficient production of normal blood cells
Neutropenia- fever and infection Anemia- weakness and fatigue Thrombocytopenia- bleeding tendencies
Due to the proliferation of leukemic cells withinorgans
Pain from an enlarged liver or spleen Hyperplasia of the gums Bone pain from the expansion of marrow
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The disorder develops without warning-
weeks to months
CBC results- decrease in erythrocytes andplatelets
The percentage of normal cells are vastlydecreased
Bone marrow analysis- shows an excess of immature blast cells
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Bleeding and infection- the leading cause of
death
Common sites of bleeding: gastrointestinal,pulmonary and intracranial
Fever and infection increases the likelihood of bleeding
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The general objective of treatment is to achieve
complete remission in which there is no
detectable evidence of residual leukemiaremaining in the bone marrow
Induction therapy- chemotherapy that aims to
eradicate all leukemic cells, but it also harmsnormal cell types