Blood cells, differentiation

Lead exposure Not a substitute for effective abatement of lead exposure. Neutropenia Mild to moderate neutropenia has been observed in some patients receiving succimer. While a causal relationship to succimer has not been definitely established, neutropenia has been reported with other drugs in the same chemical class. Obtain a complete blood count with white blood cell differential and direct platelet counts prior to and weekly during treatment. Withhold or discontinue therapy if the absolute neutrophil count (ANC) is below 1200/mcL and follow the patient closely to document recovery of the ANC to above 1500/mcL or to the patient s baseline neutrophil count. There is limited experience with reexposure in patients who have developed neutropenia. Therefore, rechallenge such patients only if the benefit of succimer therapy clearly outweighs the potential risk of another episode of... 

The various organs of the immune system such as spleen, lymph nodes, thymus and bone marrow containing the cells involved in the various immune responses offer the possibility to harvest these cells and perform in vitro assays for evaluation of effects on the immune system. When part of an in vivo animal study this may indicate a direct toxic effect of pharmaceuticals, that is, immunosuppression (Table 18.2). So, it is feasible to obtain cell suspensions for further evaluation such as determination of cellular subsets of T and B leukocytes by fluorescent activated cell sorter analysis (FACS analysis), and determination of natural killer (NK) cell activity of the spleen cell population. An advantage of this approach is that it may lead to identification of a biomarker to be used in clinical studies. In addition, in vitro stimulation of spleen cells with mitogens activating specific subsets may indicate potential effects on the functionality of splenic cell populations. Concanavalin A (Con A) and phytohemagglutinin (PHA) activate Tcells, while lipopolysaccharide (LPS) activates primarily B cell populations. Blood is collected for total white blood cell (WBC) determination and blood cell differential count. In addition, serum can be obtained for determination of serum immunoglobulins. 

Verthelyi, D., Ishii, K., Gursel, M., Takeshita, F. and Klinman, D. (2001) Human peripheral blood cells differentially recognize and respond to two distinct CPG motifs. J. Immunol., 166,2372-2377. 

PCWP F102 White blood cells/differential BUN... 

By 1935 a technologist could perform a complete blood count (CBC) consisting of WBC in 103/ J,L, RBC in 10 / LL, HGB in g/dL, HCT in %, MCV in fL (10-15 L), MCH in pg, MCHC in g/dL, and PLT in 103/pL and a complete white blood cell differential count, consisting of all white blood cell types, ie, the five normal types plus any other cells not normally found in peripheral blood. 

Magli MC, Largman C, Lawrence HJ. Effects of HOX homeobox genes in blood cell differentiation. J Cell Physiol. 1997 Nov 173(2) 168-77. 

Red cell, white cell, platelet counts, white blood cell differential, hematacrit and red cell indices must be performed by an accredited laboratory. The normal ranges for the red cell and white cell counts are influenced by altitude, race, and sex, and therefore should be determined by the acaedited laboratory in the specific area where the tests are performed. 

FIGURE 9.1 A simplified hierarchy of blood cell differentiation. Hematopoietic cells are arranged in a hierarchy of stem, progenitor, precursor and mature cells. Differentiation is a down-hill process, in that the progeny of a stem cell that has committed to differentiation cannot regain stem cell properties of extensive self-renewal and differentiation capacity. 

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