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Textbook
Introduction
1. Anatomy
2. Microbiology
3. Physiology
4. Pathology
4.1 General pathology
4.2 Central and peripheral nervous system
4.3 Cardiovascular system
4.4 Respiratory system
4.5 Hematology and oncology
4.5.1 Coagulation cascade
4.5.2 Blood cell lineages
4.5.3 Anemia fundamentals
4.5.4 Thalassemia
4.5.5 Sideroblastic anemia
4.5.6 Macrocytic anemias
4.5.7 Hemolytic anemias
4.5.8 Sickle cell disease (SCD)
4.5.9 Hereditary spherocytosis (HS)
4.5.10 Disorders of coagulation
4.5.11 Hypercoagulable disorders (Thrombophilias)
4.5.12 Platelet disorders
4.5.13 Leukemias
4.5.14 Lymphomas
4.5.15 Polycythemia vera
4.5.16 Miscellaneous disorders
4.5.17 Additional information
4.6 Gastrointestinal pathology
4.7 Renal, endocrine and reproductive system
4.8 Musculoskeletal system
5. Pharmacology
6. Immunology
7. Biochemistry
8. Cell and molecular biology
9. Biostatistics and epidemiology
10. Genetics
11. Behavioral science
Wrapping up
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4.5.2 Blood cell lineages
Achievable USMLE/1
4. Pathology
4.5. Hematology and oncology

Blood cell lineages

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Before birth, hemopoiesis occurs primarily in the liver and spleen. Some cells also develop in the thymus, lymph nodes, and red bone marrow. After birth, most blood cell production is limited to red bone marrow in specific regions, although some white blood cells are produced in lymphoid tissue.

All types of formed elements develop from a single cell type: the stem cell (pluripotent cells or hemocytoblasts). Seven different cell lines develop from the hemocytoblast, and each line is controlled by a specific growth factor.

Hemocytoblasts can give rise to either myeloid or lymphoid lineages:

  • Lymphoid lineage cells include T, B, and natural killer (NK) cells.
  • Myeloid lineage cells include megakaryocytes, erythrocytes, granulocytes and macrophages (GM).

Common lymphoid progenitors (CLPs) can differentiate into all types of lymphocytes. Common myeloid progenitors (CMPs) can give rise to all classes of myeloid cells. Dendritic cells can arise from either CLPs or CMPs.

Megakaryocytes give rise to platelets. Granulocytes include neutrophils, eosinophils and basophils and have cytoplasmic granules. Lymphocytes and monocytes are agranulocytes.

Bone marrow precursors and lineages
Bone marrow precursors and lineages
Neutrophil and monocyte in PS
Neutrophil and monocyte in PS

Neutrophil (left) and monocyte (right) in a thin blood smear, stained with Giemsa.

Small lymphocyte in PS
Small lymphocyte in PS

Small lymphocyte in a thin blood smear, stained with Giemsa

Sites of Hemopoiesis

  • Before birth: liver, spleen (primary); thymus, lymph nodes, red bone marrow (some cells)
  • After birth: mainly red bone marrow; some WBCs in lymphoid tissue

Stem Cells and Lineages

  • All formed elements from hemocytoblasts (pluripotent stem cells)
  • Seven cell lines, each regulated by specific growth factors

Myeloid vs. Lymphoid Lineages

  • Hemocytoblasts differentiate into:
    • Myeloid lineage: megakaryocytes, erythrocytes, granulocytes, macrophages
    • Lymphoid lineage: T cells, B cells, NK cells
  • Dendritic cells: can derive from either lineage

Progenitor Cells

  • Common lymphoid progenitors (CLPs): all lymphocytes
  • Common myeloid progenitors (CMPs): all myeloid cells

Formed Elements and Characteristics

  • Megakaryocytes: source of platelets
  • Granulocytes: neutrophils, eosinophils, basophils (contain cytoplasmic granules)
  • Agranulocytes: lymphocytes, monocytes (lack granules)

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Blood cell lineages

Before birth, hemopoiesis occurs primarily in the liver and spleen. Some cells also develop in the thymus, lymph nodes, and red bone marrow. After birth, most blood cell production is limited to red bone marrow in specific regions, although some white blood cells are produced in lymphoid tissue.

All types of formed elements develop from a single cell type: the stem cell (pluripotent cells or hemocytoblasts). Seven different cell lines develop from the hemocytoblast, and each line is controlled by a specific growth factor.

Hemocytoblasts can give rise to either myeloid or lymphoid lineages:

  • Lymphoid lineage cells include T, B, and natural killer (NK) cells.
  • Myeloid lineage cells include megakaryocytes, erythrocytes, granulocytes and macrophages (GM).

Common lymphoid progenitors (CLPs) can differentiate into all types of lymphocytes. Common myeloid progenitors (CMPs) can give rise to all classes of myeloid cells. Dendritic cells can arise from either CLPs or CMPs.

Megakaryocytes give rise to platelets. Granulocytes include neutrophils, eosinophils and basophils and have cytoplasmic granules. Lymphocytes and monocytes are agranulocytes.

Neutrophil (left) and monocyte (right) in a thin blood smear, stained with Giemsa.

Small lymphocyte in a thin blood smear, stained with Giemsa

Key points

Sites of Hemopoiesis

  • Before birth: liver, spleen (primary); thymus, lymph nodes, red bone marrow (some cells)
  • After birth: mainly red bone marrow; some WBCs in lymphoid tissue

Stem Cells and Lineages

  • All formed elements from hemocytoblasts (pluripotent stem cells)
  • Seven cell lines, each regulated by specific growth factors

Myeloid vs. Lymphoid Lineages

  • Hemocytoblasts differentiate into:
    • Myeloid lineage: megakaryocytes, erythrocytes, granulocytes, macrophages
    • Lymphoid lineage: T cells, B cells, NK cells
  • Dendritic cells: can derive from either lineage

Progenitor Cells

  • Common lymphoid progenitors (CLPs): all lymphocytes
  • Common myeloid progenitors (CMPs): all myeloid cells

Formed Elements and Characteristics

  • Megakaryocytes: source of platelets
  • Granulocytes: neutrophils, eosinophils, basophils (contain cytoplasmic granules)
  • Agranulocytes: lymphocytes, monocytes (lack granules)