KULPAR

PATKLIN&LABMED
SM 3 AUGT-DES 2023

HEMATOLOGI DASAR I
DR. VIVI KEUMALA MUTIAWATI, SPPK., M.KES
DEPARTEMENT OF CLINICAL PATHOLOGY AND LABORATORY MEDICINE
MEDICAL FACULTY OF SYIAH KUALA UNIVERSITY
DARUSSALAM - BANDA ACEH
INDONESIA
 KULPAR
PATKLIN&LABMED

HEMATOLOGI DASAR I
SM 3 AUGT-DES 2023

Introduksi Ilmu: Hematologi, Hemostasis, Imunohematologi, Kedokteran Transfusi.

Sistem Hematopoietik - Organ & Sel Dalam Sistem Hematopoietik.
Proses Hematopoiesis - Sumsum Tulang/SSTL (Bone Marrow/BM), Hepar, Lien, Ginjal &
Kelenjar Getah Bening/Limfe.
Sitokin & Hormon Pertumbuhan/Growth Hormone untuk Pembentukan Sel Darah
Sel Punca/Stem Cell, Sel Progenitor 1, Sel Progenitor 2, & Sel Matur Dalam Sirkulasi.
D R . V I V I K E U M A L A M U T I AWAT I , S P P K . , M . K E S
D E PA RT E M E N T O F C L I N I C A L PAT H O L O G Y A N D L A B O R ATO RY M E D I C I N E
M E D I C A L FA C U LT Y O F S Y I A H K U A L A U N I V E R S I T Y
DARUSSALAM - BANDA ACEH
INDONESIA
 Hematologi, Hemostasis, Imunohematologi,
Kedokteran Transfusi
Hematologi Hemostasis Imunohematologi Kedokteran Transfusi
Hematology is the Hemostasis is the Immunohematology is Transfusion medicine
study of blood and body's natural reaction the study of RBC (TM) is a field of
blood disorders. to an injury that stops antigens and antibodies medicine dealing with
bleeding and repairs the associated with blood the removal and/or
Hematologists and damage. transfusions. transfusion of blood or
hematopathologists blood components.
are highly trained the stoppage of There are more than 230
healthcare providers bleeding. (the stoppage types of antigens present TM has been thought of
who specialize in of the circulation of on the surface of RBCs as blood collection,
diseases of the blood blood in a part of the that, based on their pretransfusion testing,
chemical structure, can
and blood body). be grouped into two and blood
components. major categories— administration.
This capability is
These include blood usually for your benefit, carbohydrates and Blood transfusion is a
and bone marrow conserving blood and polypeptides. medical therapy that
cells. preventing infections. can be life-saving.
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hematology#
https://www.sciencedirect.com/topics/medicine-and-dentistry/immunohematology#
https://www.aabb.org/news-resources/resources/transfusion-medicine
https://my.clevelandclinic.org/health/symptoms/21999-hemostasis
 Is hematology a clinical pathology?
Clinical pathology is itself divided into subspecialties, the main ones being clinical chemistry,
clinical hematology/blood banking, hematopathology and clinical microbiology and emerging
subspecialties such as molecular diagnostics and proteomics.
Many areas of clinical pathology overlap with anatomic pathology

Patologi Klinis yang Utama adalah:

◦ Hematologi klinis.
◦ Kedokteran transfusi (lebih dikenal dengan perbankan darah)
◦ Hematopatologi.
◦ Kimia klinis.
◦ Mikrobiologi klinis.
◦ Molekuler & proteomik (lebih dikenal dengan Biologi Molekuler).
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hematology#
https://www.sciencedirect.com/topics/medicine-and-dentistry/immunohematology#
https://www.aabb.org/news-resources/resources/transfusion-medicine
https://my.clevelandclinic.org/health/symptoms/21999-hemostasis
 The hematopoietic system is responsible for the continuous production of

Sistem Hematopoietik
highly specialized mature circulating blood cells.
Due to its high metabolic and proliferative rate, and because the functions
performed by blood cells are vital to an organism, this system is highly
susceptible to direct and indirect xenobiotic-induced injury.

Organ Hematopoietik:
The haematopoietic system is the system of organs and tissues, including the
bone marrow, spleen, thymus and lymph nodes, involved in the production of
cellular blood components.
The hematopoietic system is a self-renewal system in which hematopoietic stem cells divide and
differentiate to produce maturing progeny as well as self-renew to maintain a pool of stem cells for the life
of the individual.
The hematopoietic system provides for the regulated production of the complete complement of mature
blood cells in the peripheral circulation, which includes neutrophils, eosinophils, basophils, monocytes,
lymphocytes megakaryocytes (platelets), and erythrocytes.
These mature blood cells have a limited life span, which ranges from hours for granulocytes to weeks for
erythrocytes and years for some lymphocytes.
 Sistem Hematopoietik
The hematopoietic system is a self-renewal system in
which hematopoietic stem cells divide and differentiate
to produce maturing progeny as well as self-renew to
maintain a pool of stem cells for the life of the individual.
The hematopoietic system provides for the regulated
production of the complete complement of mature blood
cells in the peripheral circulation, which
includes neutrophils, eosinophils, basophils, monocytes,
lymphocytes megakaryocytes (platelets), and
erythrocytes.
These mature blood cells have a limited life span, which
ranges from hours for granulocytes to weeks for
erythrocytes and years for some lymphocytes.
Organ & Sel pada Sistem Hematopoietik
• Sumsum tulang/SSTL
(bone marrow/BM)
• Hepar
• lien
• ginjal (eritropoietin)
• kelenjar limfe

Munculnya Menetap

Matang & berkembang

DEVELOPMENT OF THE HEMATOPOIETIC SYSTEM.
In the adult, all blood cell types are produced from hematopoietic stem cells (HSCs) that reside in
the bone marrow (BM).

The pool of HSCs is maintained in specific niches (endosteal and perivascular) where they are in
close contact with the surrounding microenvironment.
Adult HSCs are generated during embryonic development.

First detected in the aorta-gonad-mesonephros (AGM) region and in the vitelline/ umbilical
vessels, HSCs are then found in other highly vascularized tissues including the yolk sac, placenta
and fetal liver.

At mid-gestation, HSCs massively expand in the placenta and fetal liver the latter of which
becomes the main hematopoietic tissue until BM colonization at birth.

Although many extrinsic and intrinsic regulators of BM HSCs have been indentified, very little is
known about the factors involved in the regulation of embryonic and fetal HSCs.
 Organ & Sel pada Sistem Hematopoietik

Munculnya Menetap
M.Komorniczak Illustration by : Michał Komorniczak This file has been released into the Creative Commons 3.0. Attribution-ShareAlike (CC BY-SA 3.0) If you use on your website or in your publication my images (either original or modified), you are requested to give me details: Michał Komorniczak (Poland) or Michal
Komorniczak (Poland). For more information, write to my e-mail address: m.komorniczak.pl@gmail.com - Own work based on: B.F. Rodak, G.A. Fritsma. K. Doig: Hematology: Clinical Principles and Applications. 3rd ed.. Saunder, 2007. ISBN 9781416030065 Figure 7-1 R. Hoffman et al.: Hematology: Basic Principles and
Practice, 5th ed.. Philadelphia: Churchill Livingstone, An Imprint of Elsevier, 2009. ISBN 978-0-443-06715-0. I. Damjanov: Patofizjologia, Wrocław 2010, Elsevier Urban & Partner. ISBN 9788376092010 File:Human skeleton front no-text no-color.svg by: LadyofHats Mariana Ruiz Villarreal
 HEMATOPOIESIS
Fungsi: Sistem yang bertanggung jawab dalam pembentukan sel darah.
Semua sel darah berasal dari
SEL INDUK PLURIPOTEN/STEM CELL kemudian berdiferensiasi
menjadi:

1. Sel induk limfoid: membentuk sel seri limfosit & sel plasma.
2. Sel induk multipotensial myeloid (nonlimfoid): membentuk dan
berkembang menjadi berbagai jenis sel hematopoietik lain.
HEMATOPOIESIS
 HEMATOPOIESIS

https://clinicalgate.com/hematopoietic-stem-cells/
HEMATOPOIESIS
 Sitokin & hormon
pertumbuhan/growth
hormone
pembentukan sel darah membutuhkan sitokin & GH
 Sitokin & hormon
pertumbuhan/growth hormone
pembentukan sel darah
Cytokines, interferons, and
hematopoietic growth factors
In addition to their effects on
hematopoiesis and immunocompetence,
“hematopoietic” growth factors influence
multiple organ systems, including (but not
limited to) bone remodeling,
cardiorespiratory function, hepatic function,
and the gastrointestinal tract.

https://oncohemakey.com/cytokines-interferons-and-hematopoietic-growth-factors/
There are different types of cytokines,
including: They can act alone,
- Chemokines. work together or work
- Interferons. against each other, but
- Interleukins. ultimately the role of
cytokines is to help
- Lymphokines. regulate the immune
- Tumor necrosis factor. response.
Cytokines
These cells are constantly sending out signals to let other cells know what's going on.
To communicate, your immune cells use cytokines, which are a group of proteins secreted by
cells of the immune system that act as chemical messengers.
Cytokines released from one cell affect the actions of other cells by binding to receptors on
their surface.
Some class1 cytokine receptors share common subunits.
Class 1 cytokine receptors comprise three families of heterodimeric receptors each of which shares a common
receptor: (a) the common β-chain; (b) the gp130 receptor or (c) the common γ-chain.
The G-CSF, EPOR and c-MPL receptors, which consist of homodimers, are also part of the class 1 cytokine
receptor family (not shown). EPOR = erythropoietin receptor; G-CSF = granulocyte colony-stimulating factors.
Proses hematopoiesis
Setelah pembentukan Progenitor 1 &
2, terbagi lagi menjadi:

ERITROPOIESIS:
Dari sel induk multipoten membentuk
pelopor seri eritroid: eritrosit

GRANULOPOIESIS:
Dari sel induk multipoten mieloid
membentuk pelopor seri granuloid:
granulosit

TROMBOPOEISIS:
Dari sel induk multipoten myeloid
membentuk pelopor seri megakariosit:
trombosit

DEVELOPMENT OF HEMATOPOIETIC SYSTEM

Sel Darah Imatur berada di
dalam SSTL

Sel Darah Matur berada di

dalam Sirkulasi https://commons.wikimedia.org/wiki/File:Hematopoietic_growth_factors.png
PUSTAKA ACUAN
= References
 SYUKRAN
TERIMAKASIH
THANK YOU