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1. Which hemopoietic growth factor regulates differentiation and proliferation of red blood cell precursors? 2. How might your hematocrit change if you moved from a town at sea level to a high mountain village? 3. What is the function of transferrin? 4. In what way is the "traffic pattern" of lymphocytes in the body different from that of other WBCs? 5. What is a differential white blood cell count? 6. How are cord-blood transplants and bone marrow transplants similar? How do they differ? 7. Which three mechanisms contribute to hemostasis? 8. Why is the firstborn baby unlikely to have hemolytic disease of the newborn? 9. What is hemolysis, and how can it occur after a mismatched blood transfusion? 10. Mrs. Brown is in renal failure. Her recent blood tests indicated a hematocrit of 22 . Why is her hematocrit low? What can she be given to raise her hematocrit? .

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What other blood cell related problems are often seen in patients with chronic leukemia? Citereferencesplease Solution The term leukemia is referred to neoplasm of hematopoietic tissue. Unlike the solid tumors the leukemic cells diffuse into bone marrow and lymphoid tissues and spill over into blood stream to spread to various organs of the body. The leukemic cells are either mature or extremely primitive. Rich amounts of white blood cell counts in leukemia reveals the spread of tumors to peripheral blood. However, the proliferation of white blood cells is mostly confined to bone marrow and no significant increase in number of white blood cells in the blood stream can be observed. Leukemia is classified depending on the type of the cell and maturity of proliferating cell. Any type of hematopoietic cell may produce leukemia but most common types are granulocytic, monocytic and lymphocytic. The leukemia developing from stem cells produce the leukocytes containing specific granules such as neutrophils, eosinophils and basophils. This type of leukemia is called granulocytic leukemia. Monocytic leukemia is developed from the precursor cells of monocytes. Lymphocytic leukemia is produced by lymphoid precursor cells. When the leukemic cells are most primitive forms the neoplasm is called acute leukemia. The leukemia with mature cells is called chronic leukemia. Chronic granulocyte leukemia is caused by circulating matured granulocytes and neutrophils along with few primitive cells. Chronic lymphocytic leukemia is caused by circulating mature lymphocytes. The clinical features of leukemia are either caused by impairment of function of bone marrow or caused by infiltration of leukemic cells into viscera. The overgrowth of leukemic cells in bone marrow crowds out the normal cells leading to anemia because of inadequate production of red blood cells. Bleeding is caused by thrombocytopenia and infection resulting from insufficient numbers of white blood cells to provide protection by immune defense mechanism against pathogens. Leukemic cells spreading to other tissues may invade into spleen, liver, lymph nodes and other tissues. The chronic leukemia proceeds at a slow rate and can be controlled by treatment over long periods of time. Therefore, the patient may survive for several years. In an acute leukemia the disease is rapidly progressive and leukemic cells infiltrate bone marrow and viscera with conspicuous appearance. 1.American Cancer Society. Cancer Facts and Figures 2016. Atlanta, Ga: American Cancer Society; 2016. 2. Byrd JC, Brown JR, O\'Brien S, et al. Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia. N Engl J Med. 2014 Jul 17;371(3):213-23. Epub 2014 May 31. 3. Byrd JC, Furman RR, Coutre SE, et al. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med. 2013 Jul 4;369(1):32-42. Epub 2013 Jun 19. 4. Byrd JC, Flynn JM. Chronic lymphocytic leukemia. In: Niederhuber JE,Armitage JO, Doroshow .

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