Konsep Dasar Sistem Hematologi

Hematology System
Basic Concepts
Contents:
Blood components
Haemopoiesis
Blood typing
Haemostasis
Introduction
Hematology: the study of blood and blood forming
tissues.
Blood consists of 55% plasma and 45% formed
elements.
Formed elements include erythrocytes, leukocytes,
and thrombocytes.
Blood Components
Blood
Formed Plasma
elements 55% of blood volume
Erythrocytes Water
(red blood Electrolytes
cells) Plasma proteins
Leukocytes Albumin
(white blood Fibrinogen
cells) Globulins
Substances
Platelets (cell
transported by blood
fragments)
Nutrients
Waste products
Respiratory gases
Hormones
Components of Blood
Plasma
Transport mechanism
90-92% water.
6-7% proteins
2-3%
Fats
Carbohydrates
(glucose)
Electrolytes
Gases (O2, CO2)
Chemical messengers
*
Erythrocytes
Normal range 4.2-5.5
million per mm3 in
adults.
Biconcave shape.
Non-nucleated.
Diameter 7 microns.
Carriers of oxygen and
nutrients
Life span 120 days.
Erythrocytes (red blood cells)
Leukocytes
Size 8-20 microns.
Involved in fighting
infection,
combating allergic
reactions, and
immune
responses.
Leukocytes
Leukocytes (cont.)
Granulocytes
Neutrophil
Basophil
Eosinophil
Human Neutrophil:
Monocytes Phagocytosis of Strep pyogene
Lymphocytes
Neutrophils
Occurance
60-70% of all white
blood cells
Most common
leukocyte
Appearance
Multilobed nucleus
3-5 lobes
clear granules
10-15 m
Neutrophil function
Earliest to arrive in an infection
Main component of pus
Professional phagocyte
Opsonization increases phagocytic activity
Coating with antibodies and complement
Highly motile cells

Respond to chemotactic factors
released from damaged tissue
Leave blood circulation
Neutrophil
function
Eosinophils
Occurance
1-6% of WBCs of all white blood
cells
Appearance
Multilobed nucleus
red-orange granules
10-15 m
Function
Phagocytic cells with an affinity
for parasites
Receptors for IgE
Plays a role in decreasing
hypersensitivity reactions
Basophils
Occurance
<1% of all white blood cells
Least common leukocyte
Appearance
Multilobed nucleus
blue granules
10-15 m
Function
Immediate hypersensitivity
responses (allergies)
Histamine and other
mediators of inflammatory
response
Lymphocytes
Occurance
25% of all white blood
cells
Appearance
Round nucleus
about 90% of cell
Agranular
8-10 m
Cannot distinguish
between B and T
lymphocytes under
microscope
Lymphocyte function
B lymphocytes
become plasma cells
produce antibodies
B cells formed in bone marrow and travel to lymph
nodes, lymph nodules and spleen
T cells
migrate from bone marrow and mature in thymus
Have many immune functions
Monocytes
Occurance
25% of WBC
Appearance
Large nucleus
Horseshoe or
kidneybean shape
About 50% of the cell
No granules
10-20 m
Monocyte function
Transform into macrophages
After leaving bloodstream
More phagocytic than neutrophils
Primary antigen processing and presenting cell
Monocyte-macrophage system
Skin--Langerhans cell
Bone--Osteoclast
Liver--Kuppfer cell
Brain--Microglia
Thrombocytes
Smallest cells in the

blood.
Normal range 130,000-
400,000/ l
Active role in
coagulation and
hemostasis.
Platelets
Pieces of cells broken from megakaryocytes in marrow
2 m
Have many organelles but no nucleus
Important in blood clotting
Platelet anatomy
Open canalicular system
Granules
Alpha granule
Glycogen granules
Dense core granule
Organelles
Lysosomes &
peroxisomes
Microtubules
Mitochondria
Golgi region
Haemopoiesis
Haemopoiesis
(blood cell formation)
1. Erythropoiesis RBC
2. Myelopoiesis WBC granulocytes and
monocytes
3. Thrombopoeisis platelets
Site of haemopoiesis :
Fetus :
0-2 months (Yolk Sac)
2-7 months (Liver, Spleen)
5-9 months (Bone marrow)
Infants : bone marrow (practically all bones)
Adults : vertebrae, ribs, sternum, skull, sacrum
and pelvis, proximal ends of femur
Extra medullary haemopoiesis
liver spleen (eg myelofibrosis)
Haemopoiesis
Haemopoiesis
Maturation
Sequence
Bone marrow stroma
The bone marrow forms a suitable environment for stem
cell growth and development.
It is composed of stromal cells and a microvascular network
Stromal cell :
Adipocytes
Fibroblasts Secret extracellular Form extra
Reticulum cells Molecule Cellular matrix
(collagen, glycoprotein,
Endothelial cell
glycosaminoglycan
macrophages
Haemopoietic growth factors (HGF)
HGF are glycoprotein hormon

that regulate the
proliferation and diff of
hemopoietic progenitor cells
and the function of mature
blood cell
Source of growth factor :
T lymphocytes
Monocytes and
macrophage
Kidney
Liver
Haemopoietic Growth Factor
T lymphocytes -interleukin-1 (IL-1)

Release
Macrophage -tumor necrosis factor (TNF)
Kidney synthesis eryhtropoietin
Liver produces thrombopoietin

Blood Typing
Blood Products and Blood Typing
Blood Types
Antigens
A, B, AB, O
Rh factor
Rh+ = ~85%
Rh- = ~15%
Blood transfusion
Blood Typing - ABO

Blood type Antigen Antibody
present on present in
erythrocyte serum
O None Anti-A, Anti-B
AB A and B None
B B Anti-A
A A Anti-B
Compatibility Among ABO Blood
Groups
Reaction with serum of Recipient
Donor Cells AB B A O
AB - + + +
B - - + +
A - + - +
O - - - -
-: no reaction
+: reaction
Hemostasis
Proses hemostasis
Primer
Tahap vaskular
Tahap trombosit
Sekunder
Tahap faktor koagulasi
MEKANISME HEMOSTASIS NORMAL
Coagulation cascade
Factor VII
Vitamin K antagonist
Anti-thrombin III
Activated Protein C
Thank You
Hemapoietic growth factors
1. Act on stromal cells : 4. Act on commited progenitor
IL-1
cells
TNF
2. Act on pluripotential stem - G-CSF
cells : - M-CSF
Stem cell factor (SCF) - IL-5
Flt (Flt-L) - Erythropoietin
3. Act on multipotential
- Thrombopoietin
progenitor cells
IL-3 5. Totipotent cell :
GM-CSF embryonic stem cells are
IL-6 totipotent since they can
G-CSF

generate all tissue of the
Thrombopoietin
body

Konsep Dasar Sistem Hematologi

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Hematology System

Highly motile cells

Smallest cells in the

HGF are glycoprotein hormon

T lymphocytes -interleukin-1 (IL-1)

Kidney synthesis eryhtropoietin

Liver produces thrombopoietin

Blood Typing - ABO

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