Malignant disorder of white

blood cells
Introduction

White blood cells (leukocytes) are an important part

of the body’s defense against infectious organisms and
foreign substances (the immune system).

To defend the body adequately, a sufficient number

of white blood cells must receive a message that an
infectious organism or foreign substance has invaded
the body, get to where they are needed, and then kill
and digest the harmful organism or.
Introduction

Like all blood cells, white blood cells are produced primarily in
the bone marrow. They develop from stem (precursor) cells that
mature into one of the five major types of white blood cells:
• Neutrophils
• Lymphocytes
• Monocytes
• Eosinophils
• Basophils
Introduction

Normally, people produce about 100 billion white blood

cells a day.

The number of white blood cells in a given volume of

blood is expressed as cells per microliter of blood.

The total white blood cell count normally ranges between

4,000 and 11,000 cells per microliter (4 to 11 × 109 per
liter).
Too few or too many white blood cells
indicates a disorder.
 Leukopenia

A decrease in the number of

white blood cells to fewer than
4,000 cells per microliter of
blood (4 × 109 per liter),
frequently makes people more
susceptible to infections.
 Leukocytosis

An increase in the number of white blood cells to more

than 11,000 cells per microliter of blood.
It is often caused by the normal response of the body
to help fight an infection, or to some drugs such as
corticosteroids.
However, an increase in the number of white blood
cells is also caused by cancers of the bone marrow
(such as leukemia).
Some white blood cell disorders involve only one of the five types of
white blood cells.
Lymphocytic leukocytosis

Lymphocytes are a type of white blood cell that play several roles in

the immune system, including protection against bacteria, viruses,
fungi, and parasites.
There are three types of lymphocytes
• B cells (B lymphocytes)
• T cells (T lymphocytes)
• Natural killer cells
All three types can be increased in response to infections or cancer.
However, in some cases only a specific type of lymphocyte is
increased.
Lymphocytic leukocytosis

Lymphocytic leukocytosis is an abnormally

high number of lymphocytes in the blood.

The most common cause of an increased

number of lymphocytes is Viral infection
(such as mononucleosis).

Treatment for lymphocytic leukocytosis

depends on the cause.
Lymphocytopenia

Lymphocytopenia is an abnormally low number of lymphocytes in

the blood.
Lymphocytes usually constitute (20 to 40)% of all white blood cells
in the bloodstream.
The lymphocyte count is normally above 1,500 cells per microliter
of blood in adults and above 3,000 cells per microliter of blood in
children.
A reduction in the number of lymphocytes may not cause a
noticeable decrease in the total number of white blood cells.
Causes

Various disorders and conditions, including infection with viruses

such as human immunodeficiency virus (HIV)—the virus that causes
AIDS—and the influenza virus can decrease the number of
lymphocytes in the blood. Lymphocytopenia can be

• Acute: Occurring briefly during certain conditions and then usually

resolving
• Chronic: Occurring for a longer period because of long-lasting
disorders
Causes of acute lymphocytopenia

• The number of lymphocytes can temporarily decrease during

• Certain viral infections (such as influenza and hepatitis)
• Fasting
• Times of severe physical stress
• Use of corticosteroids (such as prednisone)
• Chemotherapy and/or radiation therapy for cancer
Causes of chronic lymphocytopenia

The number of lymphocytes can remain low for a long time when
people have:

• Undernutrition
• Certain autoimmune disorders, such as systemic lupus
erythematosus (lupus), rheumatoid arthritis, and myasthenia
gravis
• Certain chronic infections, such as AIDS and miliary tuberculosis
• Certain cancers, such as leukemias and lymphomas
Neutropenia

Neutropenia is an abnormally low number of neutrophils (a type

of white blood cell) in the blood.

Neutrophils are a type of white blood cell that serve as the body's

major defense against acute bacterial and certain fungal infections.

Neutrophils usually constitute about (45 to 75) % of all white blood cells
in the bloodstream.

Without the key defense provided by neutrophils, people have problems

controlling infections and are at risk of dying from an infection.
Severity of neutropenia

The typical lower limit of the neutrophil count is about 1500 cells per
microliter of blood.

As the count goes below this level, the risk of infection increases.
Neutropenia severity is classified as:

• Mild: 1000 to 1500/mcL (1 to 1.5 × 109/L)

• Moderate: 500 to 1000/mcL (0.5 to 1 × 109/L)
• Severe: below 500/mcL (0.5 × 109/L)

When the neutrophil count falls below 500 cells per microliter the
risk of infection increases greatly.
Causes

Rapid use or destruction of neutrophils

Many disorders cause neutrophils to be used up or destroyed.

These disorders include certain bacterial infections, some allergic

disorders, and some drug treatments.

People with an autoimmune disorder can make antibodies that destroy

neutrophils and result in neutropenia.

People with an enlarged spleen may have a low neutrophil count because

the enlarged spleen traps and destroys neutrophils.
Causes

Reduced production of neutrophils

Production of neutrophils in the bone marrow can be reduced by

cancer, viral infections, bacterial infections or deficiencies of
vitamin B12 or folate.

People who have received radiation therapy that involves the bone
marrow may also develop neutropenia.

Many drugs can also impair the bone marrow’s ability to produce
neutrophils.
Treatment

• Antibiotics
• Drugs to stimulate production of neutrophils

The treatment of neutropenia itself depends on its cause and

severity.
Drugs that may cause neutropenia are stopped whenever possible,
and exposures to suspected toxins are avoided.
Neutrophilic Leukocytosis

Neutrophilic leukocytosis is an abnormally high number of

neutrophils in the blood.
Neutrophils are a type of white blood cell that help the body fight
infections and heal injuries. Neutrophils may increase in response to
a number of conditions or disorders, including
• Infections
• Injuries
• Inflammatory disorders
• Certain drugs
• Certain leukemias
Causes

The normal response of the body to an infection.

The number of neutrophils may rise in people who have an injury.

Inflammatory disorders.

Some drugs.

Myeloid leukemias can lead to an increased number of immature or

mature neutrophils in the blood.
Treatment

Treatment of the underlying disorder

An increased number of mature neutrophils in the blood is not

usually a problem in itself.

Therefore, doctors focus on treating the condition or disorder that

caused the number of neutrophils to increase.
Malignant disorder of white blood cells

Other disorders may involve a few types together or all

five white blood cell types. Disorders of neutrophils and
disorders of lymphocytes are the most common.

Disorders that involve monocytes and eosinophils are less

common, and disorders involving basophils are rare.