A condition where there are fewer WBCs than

normal
Causes:
 Neutropenia
 Lymphopenia:
Neutrophil count less than 2,000/mm3
Causes:
 Decrease production of neutrophils
 Increased destruction of neutrophils.
Sequelae:
 Increase risk for infection
Increased duration of neutropenia leads to
increased risk of infection.
There is no definite symptoms of neutropenia

until the patient becomes infected.

LEUKOCYTOSIS
 Increased level of WBCs in the circulation.
 Causes:
Increase need (e.g. In acute infection)
Malignancy
LEUKEMIA
 A neoplastic proliferation of one particular cell
type (granulocytes, monocytes, lymphocytes, or
the megakaryocytes)
 There is an unregulated proliferation of WBCs in
the bone marrow
ACUTE MYELOID LEUKEMIA
 results from a defect in the hematopoietic stem
cell that differentiates into all myeloid cells:
monocytes, granulocytes (neutrophils,
basophils, eosinophils), erythrocytes, and
platelets.
 Resistant to treatment, resulting in a much
shorter duration of remision.
 With treatment, the patient survive an average
of less than 1 year, with death usually a result
of infection or hemorrhage.
 Clinical Manifestations: evolve from
insufficient production of normal blood cells.
Fever and infection  because of neutropenia
Weakness and fatigue  because of anemia
Bleeding tendencies  because of
thrombocytopenia
 Ecchymosis and petechia
Enlarged liver or spleen
Hyperplasia of the gums
Bone pain from expansion of marrow
 Complications:
bleeding
 Correlates with the level of thrombocytopenia
 Major hemorrhage occurs when the platelet counts
drops to less than 10,000/mm3
 Common sites of bleeding:
 Gastrointestinal
 Pulmonary
 intracrania
Infection
 Because of the lack of mature and normal granulocytes
CHRONIC MYELOID LEUKEMIA
 arises from the mutation in the myeloid stem
cell.
 Normal myeloid cells continue to be produced
but there is a preference for immature (blast)
forms.
 A section of DNA is missing from chromosome
22 (Philadelphia chromosome)  translocated
in chromosome 9  causes the WBC to divide
rapidly
 Patients have overall median life expectancy of
3 – 5 years.
 Clinical Manifestations:
Majority are asymptomatic
WBC count exceeds 100,000/mm3
SOB and Slightly confused due to decreased
capillary perfusion to the lungs and brain from
leukostatis
Enlarged tender spleen
Enlarged liver
ACUTE LYMPHOCYTIC LEUKEMIA
 Results from uncontrolled proliferation of
immautre cells (lymphoblast) derived from the
lymphoid stem cells.
 Most common in young children
 Clinical manifestations:
Reduced number of erythrocytes, leukocytes,
and platelets.
Pain from enlarged spleen or liver
Bone pain
headache and vomiting
CHRONIC LYMPHOCYTIC LEUKEMIA
 Common malignancy of older adults
 Derives from a malignant clone of B
lymphocytes
 Most of the cells are fully mautre.
 Clinical Manifestations:
Aysmptomatic in early stages
Elevated lymphocyte count (>100,000/mm3)
Lymphadenopathy
Hepatomegaly
Splenomegaly
Anemia
Thrombocytopenia
Anergy  absent or decreased reaction to
skin sensitivity test
infection
NEOPLASMS OF CELSS OF LYMPHOID ORIGIN
A relatively rare malignancy that has an
impressive cure rate.
Reed-Sternberg cells
 Malignant cells of Hodgkin’s disease
 Gigantic tumor cell that is morphologically
unique and is thought to be of immature
lymphoid origin.
 Pathologic hallmark and essential diagnostic
criterion for Hodgkin’s Disease
Clinical Manifestations:
 Painless enlargement of one or more
lymph nodes on one side of the neck.
Cervical lymph nodes
Supraclavicular lymph nodes
Mediastinal lymph nodes
 Mediastinal mass
dyspnea
 Pruritus
 Brief but severe pain after drinking
alcohol
 Cough and pulmonary effusion
 Jaundice
 Abdominal pain
 Bone pain
 Anergy
Malignant disease of the most mature form of
B lymphocytes, the plasma cells
Malignant plasma cells produced an increased
amount of a specific immunoglobulin that is
non-functional  monoclonal protein (M
protein)
 Serves as a useful marker to monitor the extent
of the disease and the patient’s response to
therapy.
Clinical manifestatons:
 Bone pain (usually in the back or ribs) 
classic presenting symptoms
 Lytic lesions in the bone
 Osteoporosis
Increase risk for fractures
 Hypercalcemia
Excessive thirst, dehydration, constipation, altered
mental status, confusion, coma
 Renal failure
 Anemia
 Reduced WBC and platelets