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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

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Tumor lysis syndrome

Gastrointestinal problems