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Hematology Review

Hematology Review. Tim R. Randolph. PhD, MT(ASCP) Chair and Associate Professor Department of Clinical Laboratory Science Saint Louis University. RBC Disorders. Anemias Over 30 types Myeloproliferative Neoplasm Polycythemia Leukemia AML:M6. Classification of Anemias. Two approaches

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Hematology Review

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  1. Hematology Review Tim R. Randolph. PhD, MT(ASCP) Chair and Associate Professor Department of Clinical Laboratory Science Saint Louis University

  2. RBC Disorders • Anemias • Over 30 types • Myeloproliferative Neoplasm • Polycythemia • Leukemia • AML:M6

  3. Classification of Anemias • Two approaches • RBC size • MCV • Microcytic • Normochromic • Macrocytic • Balance between i production & h destruction • Requires many lab tests • All data must be in to make diagnosis

  4. Classification of Anemias

  5. Microcytic Anemias • Iron Metabolism Problems • Iron testing

  6. Microcytic Anemias • Thalassemias • QUANTITATIVE reduction in Hb synthesis • 6 normal human globin genes • About 435 mutations • 2 major types of thalassemia • Alpha thalassemia • Beta thalassemia • Suspect when • Inherited • Mediterranean nationality • Normal iron studies

  7. Thalassemia Microcytic Anemia

  8. Microcytic Anemias • Thalassemia • Alpha-Thalassemia • Reduction in alpha containing Hb • HbA, HbA2, HbF • Increase in non-alpha containing Hb • HbBarts ( g4), HbH ( b4) • Beta Thalassemia • Reduction in beta containing Hb • HbA • Increase in non-alpha containing Hb • HbA2, HbF

  9. Normocytic Anemias

  10. Normocytic Anemias • Hemoglobinopathies • QUALITATIVE change in Hb amino acid sequence • Over 1,000 mutations • Most cause little to no symptoms • Most common types • Sickle cell (HbS) (valine for glutamic acid at 6th position) • HbC (Lysine for glutamic acid at 6th position) • HbE (Lysine for glutamic acid at 26th position) • HbO (Lysine for glutamic acid at 121st position) • HbD (Glutamine for glutamic acid at 121st position)

  11. Normocytic Anemias

  12. Normocytic Anemias

  13. Normocytic Anemias • Membrane Disorders • Hereditary Spherocytosis • Speherocytes • Hereditary Elliptocytosis • Elliptocytes • Hereditary Pyropoikilocytosis • Spherocytes & Schistocytes • Hereditary Stomatocytosis • Stomatocytes • Hereditary Xerocytosis • Blister cells/Helmet cells

  14. Normocytic Anemias • Enzyme Deficiencies • G6PD Deficiency • X-linked (males) • Crisis occurs following exposure to oxidative drugs • Sudden hemolytic crisis • Heinz Bodies • Pyruvate Kinase • Autosomal • Milder symptoms • No Heinz Bodies

  15. Normocytic Anemias

  16. Normocytic Anemias • Decreased production • Aplastic Anemia • Pancytopenia • Normal morphology • Pure Red cell Aplasias • Decrease in RBCs only • Congenital Dyserythropoetic Anemias • Dysplastic morphology (macro, multi-lobed, cell bridges) • 4 types (CDA 1,2,3,4)

  17. Normocytic Anemia

  18. WBC Disorders

  19. WBC Disorders

  20. WBC Disorders

  21. WBC Disorders

  22. WBC Disorders

  23. WBC Disorders

  24. WBC Disorders

  25. WBC Disorders

  26. WBC Disorders

  27. Thank You !!! Questions ?????

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