Hematology System

Basic Concepts
Contents:
Blood components
Haemopoiesis
Blood typing
Haemostasis
 Introduction
Hematology: the study of blood and blood forming
tissues.
Blood consists of 55% plasma and 45% formed
elements.
Formed elements include erythrocytes, leukocytes,
and thrombocytes.
Blood Components
 Blood
Formed Plasma
elements 55% of blood volume
Erythrocytes Water
(red blood Electrolytes
cells) Plasma proteins
Leukocytes Albumin
(white blood Fibrinogen
cells) Globulins
Substances
Platelets (cell
transported by blood
fragments)
Nutrients
Waste products
Respiratory gases
Hormones
 Components of Blood
Plasma
Transport mechanism
90-92% water.
6-7% proteins
2-3%
Fats
Carbohydrates
(glucose)
Electrolytes
Gases (O2, CO2)
Chemical messengers
*
 Erythrocytes
Normal range 4.2-5.5
million per mm3 in
adults.
Biconcave shape.
Non-nucleated.
Diameter 7 microns.
Carriers of oxygen and
nutrients
Life span 120 days.
Erythrocytes (red blood cells)
 Leukocytes
Size 8-20 microns.
Involved in fighting
infection,
combating allergic
reactions, and
immune
responses.
 Leukocytes

Leukocytes (cont.)
Granulocytes
Neutrophil
Basophil
Eosinophil
Human Neutrophil:
Monocytes Phagocytosis of Strep pyogene
Lymphocytes
 Neutrophils
Occurance
60-70% of all white
blood cells
Most common
leukocyte
Appearance
Multilobed nucleus
3-5 lobes
clear granules
10-15 m
 Neutrophil function
Earliest to arrive in an infection
Main component of pus
Professional phagocyte
Opsonization increases phagocytic activity
Coating with antibodies and complement

Highly motile cells

Respond to chemotactic factors
released from damaged tissue
Leave blood circulation
Neutrophil
function
 Eosinophils
Occurance
1-6% of WBCs of all white blood
cells
Appearance
Multilobed nucleus
red-orange granules
10-15 m
Function
Phagocytic cells with an affinity
for parasites
Receptors for IgE
Plays a role in decreasing
hypersensitivity reactions
 Basophils
Occurance
<1% of all white blood cells
Least common leukocyte
Appearance
Multilobed nucleus
blue granules
10-15 m
Function
Immediate hypersensitivity
responses (allergies)
Histamine and other
mediators of inflammatory
response
 Lymphocytes
Occurance
25% of all white blood
cells
Appearance
Round nucleus
about 90% of cell
Agranular
8-10 m
Cannot distinguish
between B and T
lymphocytes under
microscope
 Lymphocyte function
B lymphocytes
become plasma cells
produce antibodies
B cells formed in bone marrow and travel to lymph
nodes, lymph nodules and spleen
T cells
migrate from bone marrow and mature in thymus
Have many immune functions
 Monocytes
Occurance
25% of WBC
Appearance
Large nucleus
Horseshoe or
kidneybean shape
About 50% of the cell
No granules
10-20 m
 Monocyte function
Transform into macrophages
After leaving bloodstream
More phagocytic than neutrophils
Primary antigen processing and presenting cell
Monocyte-macrophage system
Skin--Langerhans cell
Bone--Osteoclast
Liver--Kuppfer cell
Brain--Microglia
 Thrombocytes

Smallest cells in the

blood.
Normal range 130,000-
400,000/ l
Active role in
coagulation and
hemostasis.
 Platelets
Pieces of cells broken from megakaryocytes in marrow
2 m
Have many organelles but no nucleus
Important in blood clotting
 Platelet anatomy
Open canalicular system
Granules
Alpha granule
Glycogen granules
Dense core granule
Organelles
Lysosomes &
peroxisomes
Microtubules
Mitochondria
Golgi region
Haemopoiesis
 Haemopoiesis
(blood cell formation)

1. Erythropoiesis RBC
2. Myelopoiesis WBC granulocytes and
monocytes
3. Thrombopoeisis platelets
 Site of haemopoiesis :

Fetus :
0-2 months (Yolk Sac)
2-7 months (Liver, Spleen)
5-9 months (Bone marrow)
Infants : bone marrow (practically all bones)
Adults : vertebrae, ribs, sternum, skull, sacrum
and pelvis, proximal ends of femur
Extra medullary haemopoiesis
liver spleen (eg myelofibrosis)
Haemopoiesis
Haemopoiesis
Maturation
Sequence
 Bone marrow stroma
The bone marrow forms a suitable environment for stem
cell growth and development.
It is composed of stromal cells and a microvascular network
Stromal cell :
Adipocytes
Fibroblasts Secret extracellular Form extra
Reticulum cells Molecule Cellular matrix
(collagen, glycoprotein,
Endothelial cell
glycosaminoglycan
macrophages
 Haemopoietic growth factors (HGF)

HGF are glycoprotein hormon

that regulate the
proliferation and diff of
hemopoietic progenitor cells
and the function of mature
blood cell
Source of growth factor :
T lymphocytes
Monocytes and
macrophage
Kidney
Liver
 Haemopoietic Growth Factor

T lymphocytes -interleukin-1 (IL-1)

Release
Macrophage -tumor necrosis factor (TNF)

Kidney synthesis eryhtropoietin

Liver produces thrombopoietin

Blood Typing
 Blood Products and Blood Typing
Blood Types
Antigens
A, B, AB, O
Rh factor
Rh+ = ~85%
Rh- = ~15%

Blood transfusion
Blood Products and Blood Typing

Blood Typing - ABO

Blood type Antigen Antibody
present on present in
erythrocyte serum
O None Anti-A, Anti-B
AB A and B None
B B Anti-A
A A Anti-B
Blood Products and Blood Typing
Compatibility Among ABO Blood
Groups
Reaction with serum of Recipient
Donor Cells AB B A O
AB - + + +
B - - + +
A - + - +
O - - - -
-: no reaction
+: reaction
Hemostasis
 Proses hemostasis
Primer
Tahap vaskular
Tahap trombosit
Sekunder
Tahap faktor koagulasi
MEKANISME HEMOSTASIS NORMAL
 Coagulation cascade

Factor VII

Vitamin K antagonist
Anti-thrombin III
Activated Protein C
Thank You
 Hemapoietic growth factors
1. Act on stromal cells : 4. Act on commited progenitor
IL-1
cells
TNF
2. Act on pluripotential stem - G-CSF
cells : - M-CSF
Stem cell factor (SCF) - IL-5
Flt (Flt-L) - Erythropoietin
3. Act on multipotential
- Thrombopoietin
progenitor cells
IL-3 5. Totipotent cell :
GM-CSF embryonic stem cells are
IL-6 totipotent since they can
G-CSF

generate all tissue of the
Thrombopoietin
body
MEKANISME HEMOSTASIS NORMAL
MEKANISME HEMOSTASIS NORMAL