p.6
Platelet Production and Function
What results from the increase in cytoplasmic granulation in megakaryocytes?
More granulation results in more platelets produced per megakaryocyte.
p.8
Leukaemia and Related Disorders
What causes Agammaglobulinemia?
A block in B cell development.
p.11
Haematopoiesis Process and Regulation
What is done in an aspirate assay?
Semi-liquid bone marrow is aspirated and smeared onto a slide for cell count and type analysis using a light microscope and stains.
p.9
Haematopoiesis Process and Regulation
What are the two types of growth factors in lymphocyte haematopoiesis?
Early acting growth factors and late acting growth factors.
p.5
Erythropoiesis and Its Control
How does poor kidney function affect the bone marrow's production of red cells?
It reduces the ability to upregulate bone marrow production of red cells.
p.3
Haematopoiesis Process and Regulation
How do haematopoietic tissues respond to increased cell production needs?
They can respond rapidly, e.g., in cases of blood loss or infection.
p.3
Haematopoiesis Process and Regulation
Where does haematopoiesis occur in adults?
In the bone marrow of the axial skeleton.
p.8
Leukaemia and Related Disorders
Which protein is defective in Agammaglobulinemia?
BTK (Bruton's tyrosine kinase).
p.6
Platelet Production and Function
What do the earliest progenitors of megakaryocytes look like?
The earliest progenitors of megakaryocytes look like myeloid blasts.
p.5
Erythropoiesis and Its Control
What role do oxygen sensors in the kidney play in erythropoiesis?
They act on the peritubular interstitial cells in the outer cortex of the kidney to produce EPO.
p.1
Granulocytes and Their Roles
What are the types of granulocytes?
Eosinophils, basophils, and neutrophils.
p.1
Monocytes and Their Functions
What are the key roles of monocytes?
Phagocytosis and cytokine production.
p.10
Investigating Cytopenia and Bone Marrow Evaluation
What are the two main reasons for low cell counts?
Cells are not being produced by the bone marrow (aplastic anaemia) or cells are destroyed too quickly in peripheral circulation (immune thrombocytopenia).
p.2
Other Cells Produced by Haematopoiesis
Where are mast cells produced and where do they mature?
Produced in the bone marrow but mature in tissues.
p.11
Haematopoiesis Process and Regulation
What is the purpose of evaluating haematopoiesis?
To get access to cells of the bone marrow.
p.8
Leukaemia and Related Disorders
What is the consequence of a defect in the BTK protein in Agammaglobulinemia?
Inability to progress from Pre B cell to immature B cell.
p.5
Erythropoiesis and Its Control
What controls erythropoiesis?
The kidney controls erythropoiesis.
p.4
Erythropoiesis and Its Control
Where does erythropoiesis start?
Erythropoiesis starts in the bone marrow with stem cells.
p.3
Haematopoiesis Process and Regulation
When does haematopoiesis start and where does it continue throughout life?
Starts 17 days after fertilisation and continues throughout life in our bone marrow.
p.7
Haematopoiesis Process and Regulation
What do myeloid progenitors differentiate into?
They either go down the granulocytic pathway to GMP cells and then into eosinophils, neutrophils, monocytes, or basophils, or they differentiate into MEP cells which then become erythrocytes, megakaryocytes, or platelets.
p.7
Leukaemia and Related Disorders
What causes acute leukaemia?
Maturation arrest, where a block in haematopoiesis results in lots of blasts but not the later cells in the hierarchy.
p.7
Leukaemia and Related Disorders
What is an example of leukaemia caused by over-production of mature cells?
Chronic myeloid leukaemia (CML).
p.2
Granulocytes and Their Roles
What part of the immune response are granulocytes involved in?
The innate immune response.
p.8
Haematopoiesis Process and Regulation
What is the sequence of B cell development in the bone marrow?
Stem cells differentiate into Pro B, Pre B, Immature B, and then mature B (antigen naïve).
p.8
Haematopoiesis Process and Regulation
What role do transcription factors play in haematopoiesis?
They control which genes are turned on or off by binding to DNA and promoting or blocking gene transcription.
p.5
Erythropoiesis and Its Control
How do high oxygen levels in the blood affect EPO production?
High oxygen levels result in low EPO production and vice versa.
p.7
Haematopoiesis Process and Regulation
What do Haematopoietic Stem Cells (HSC) commit to becoming?
Multipotent progenitor cells, either myeloid or lymphoid.
p.1
White Blood Cell Categories
What are the two classes of myeloid cells?
Monocytes and granulocytes.
p.10
Platelet Production and Function
What are the two types of thrombopoietin (TPO) receptor agonists?
AMG 531 (subcutaneous injection) and Eltrombopag (oral).
p.8
Leukaemia and Related Disorders
What types of cells are found in the bone marrow of someone with Agammaglobulinemia?
Lots of Stem cells, Pro B, and Pre B cells, but no immature or mature B cells in circulation.
p.4
Haematopoiesis Process and Regulation
What does it mean that haematopoietic stem cells (HSC) are multipotent?
It means they can give rise to multiple types of blood cells.
p.6
Platelet Production and Function
What is a side effect of liver dysfunction related to platelet production?
A side effect of liver dysfunction is thrombocytopenia (low blood platelet count) due to lack of TPO production.
p.4
Erythropoiesis and Its Control
What happens if red cells are being destroyed in the periphery?
Erythropoiesis will be stimulated, leading to an increase in precursors such as reticulocytes.
p.1
White Blood Cell Categories
What are the two categories of white cells?
Lymphoid cells and myeloid cells.
p.10
Erythropoiesis and Its Control
What is erythropoietin (EPO) mainly used for?
To improve anaemia in end-stage renal disease.
p.2
Lymphocytes and Adaptive Immunity
What happens to B cells once they recognize antigens?
They further differentiate in the lymph nodes.
p.8
Leukaemia and Related Disorders
What type of genetic disorder is Agammaglobulinemia?
X-linked genetic disorder.
p.8
Leukaemia and Related Disorders
What is absent in the circulation of someone with Agammaglobulinemia?
Immature or mature B cells and immunoglobulins (Ig).
p.4
Haematopoiesis Process and Regulation
What is haematopoiesis?
Haematopoiesis is the process of blood cell formation starting with a stem cell.
p.6
Platelet Production and Function
Where is the TPO receptor (c-Mpl) found?
The TPO receptor (c-Mpl) is found on megakaryoblasts, megakaryocytes, and platelets.
p.4
Erythropoiesis and Its Control
At what stage are cells committed to the erythrocyte lineage?
Cells are committed to the erythrocyte lineage once they reach the Pronomoblast stage.
p.10
Erythropoiesis and Its Control
What are some other uses of erythropoietin (EPO)?
Myelodysplasia, pre-autologous blood donation, Jehovah’s witness blood loss, and sporting abuse.
p.2
Platelet Production and Function
What happens when there are low levels of platelets?
It leads to easy bruising and hemorrhage.
p.11
Haematopoiesis Process and Regulation
What is a trephine biopsy and what is it used for?
A core of bone marrow is taken to examine cellularity, histology, and architecture of the bone marrow.
p.9
Haematopoiesis Process and Regulation
What is the role of early acting growth factors in haematopoiesis?
They act early on in the hierarchy of haematopoiesis.
p.4
Haematopoiesis Process and Regulation
What are the capabilities of haematopoietic stem cells (HSC)?
HSCs can divide indefinitely to replenish themselves and give rise to specialized, differentiated cells.
p.6
Platelet Production and Function
Where is thrombopoietin (TPO) mainly produced?
TPO is mainly produced by the liver.
p.4
Erythropoiesis and Its Control
What happens to the nucleus in cells further down the erythrocyte lineage?
The nucleus gets much smaller until it is extruded in reticulocytes.
p.4
Erythropoiesis and Its Control
Why can reticulocytes make hemoglobin (Hb) but erythrocytes cannot?
Reticulocytes still have RNA, which allows them to make hemoglobin.
p.3
Haematopoiesis Process and Regulation
Where does haematopoiesis occur in a foetus?
Initially in the yolk sac, then moving to the foetal liver.
p.7
Haematopoiesis Process and Regulation
How are later cells in the haematopoiesis pathways identified?
Via routine marrow staining.
p.10
Haematopoiesis Process and Regulation
What are the two types of haematopoietic stem cell transplants?
Autologous (from the individual) and allogeneic (from a donor).
p.10
Platelet Production and Function
What conditions are TPO receptor agonists used for?
Thrombocytopenia in myelodysplasia and post-chemotherapy to maintain/increase platelet count.
p.2
Lymphocytes and Adaptive Immunity
What part of the immune response are lymphocytes involved in?
The adaptive immune response.
p.2
Other Cells Produced by Haematopoiesis
What is the role of dendritic cells in the immune response?
To detect antigens in the tissue and present them to the innate and adaptive immune system.
p.6
Platelet Production and Function
How many platelets are produced per megakaryocyte?
Around 2000 - 3000 platelets are produced per megakaryocyte.
p.4
Erythropoiesis and Its Control
What is erythropoiesis?
Erythropoiesis is the haematopoietic pathway for erythrocytes (red blood cells).
p.3
Lymphocytes and Adaptive Immunity
What is the lifespan of lymphocytes?
Days to years, possibly for life.
p.3
Haematopoiesis Process and Regulation
What is haematopoiesis?
The process of blood cell production.
p.10
Haematopoiesis Process and Regulation
What is G-CSF used for?
Prevention of infections in neutropenic patients and mobilizing stem cells for harvests prior to transplants.
p.2
Other Cells Produced by Haematopoiesis
What are dendritic cells and where are they found?
Professional antigen-presenting cells found in tissues.
p.11
Haematopoiesis Process and Regulation
What are the two types of assays used to evaluate bone marrow?
Aspirate and Trephine Biopsy.
p.11
Haematopoiesis Process and Regulation
What does a hypocellular bone marrow indicate?
Low cell bone marrow, e.g., aplastic anaemia.
p.11
Haematopoiesis Process and Regulation
What does a normal bone marrow look like in a trephine biopsy?
It has lots of little cells.
p.6
Platelet Production and Function
From which cells do platelets arise?
Platelets arise from the cytoplasm of megakaryocytes in the bone marrow.
p.9
Haematopoiesis Process and Regulation
Can you name some examples of early acting growth factors?
Stem cell factor, Flt 3 ligand, IL-3, TPO.
p.6
Platelet Production and Function
Why do megakaryocytes enlarge?
Megakaryocytes enlarge due to nuclear divisions (endomitosis).
p.9
Haematopoiesis Process and Regulation
What is the role of late acting growth factors in haematopoiesis?
They act late in the hierarchy of haematopoiesis.
p.6
Platelet Production and Function
What regulates platelet production?
Platelet production is regulated by thrombopoietin (TPO).
p.5
Erythropoiesis and Its Control
What does EPO stimulate in the bone marrow?
EPO stimulates the later stages of erythropoiesis in the bone marrow.
p.5
Erythropoiesis and Its Control
What might poor kidney function mean for EPO production?
Poor kidney function may mean an individual cannot produce EPO.
p.5
Erythropoiesis and Its Control
Why is EPO usually given in cases of renal failure?
Because individuals with renal failure may not be able to produce EPO.
p.4
Erythropoiesis and Its Control
What do reticulocytes differentiate into?
Reticulocytes differentiate into red blood cells, which then pass into circulation.
p.3
Haematopoiesis Process and Regulation
What regulates haematopoiesis?
Growth factors and cytokines.
What are the three types of blood cells?
Red cells (erythrocytes), platelets, and white cells (leucocytes).
p.3
Haematopoiesis Process and Regulation
Where does haematopoiesis occur in infants?
In the bone marrow of virtually all bones.
p.7
Lymphocytes and Adaptive Immunity
What do lymphoid progenitors differentiate into?
T lymphocytes, B lymphocytes, or NK cells.
p.10
Investigating Cytopenia and Bone Marrow Evaluation
What are the three methods to increase cell counts when they are low?
Replace them, use growth factors, and use thrombopoietin receptor agonists.
p.7
Leukaemia and Related Disorders
What is an example of acute leukaemia caused by maturation arrest?
Acute myeloblastic leukaemia (AML).
p.10
Haematopoiesis Process and Regulation
What is the purpose of haematopoietic stem cell transplants?
To repopulate the bone marrow in patients with immune deficiency or blood cancer.
p.1
Monocytes and Their Functions
What do monocytes engulf and destroy?
Dead host cells and pathogens.
p.7
Leukaemia and Related Disorders
What is the consequence of no negative feedback on haematopoiesis in the system?
It can lead to over-production of mature cells and potentially leukaemia.
p.2
Granulocytes and Their Roles
What is the primary function of neutrophils?
To engulf and destroy bacteria (phagocytes).
p.2
Granulocytes and Their Roles
What do the granules of neutrophils contain?
Lysosomes and myeloperoxidase.
p.6
Platelet Production and Function
What is used in patients with low platelets to stimulate platelet production?
Thrombopoietic growth factors (GF) are used in patients with low platelets to stimulate platelet production.
p.1
Lymphocytes and Adaptive Immunity
What are the three types of lymphoid cells?
T cells, B cells, and NK cells.
p.7
Leukaemia and Related Disorders
What happens when there is no maturation arrest in haematopoiesis?
It leads to over-production of mature cells, which can also lead to leukaemia.
p.2
Granulocytes and Their Roles
Are eosinophils phagocytic?
No, they are not phagocytic.
p.10
Erythropoiesis and Its Control
What are the risks associated with regular blood transfusions?
Patients can be given too much iron, leading to iron overload, which is toxic to the liver.
p.2
Platelet Production and Function
What is the function of the granules in platelets?
To secrete substances that control clotting and the breakdown of a blood clot.
p.2
Platelet Production and Function
Do platelets have a nucleus?
No, platelets have no nucleus.
