Hema Report PDF

By : IBRAHIM ,
RIMAN MUSTAFA ERYTHROPOIESIS

• Hemo: Referring to blood cells & Poiesis: “The development or
production of”
INTRODUCTION • Hemopoiesis or Hematopoiesis is the process of origin,

development and maturation of all the blood cell
• Erythropoiesis is the process of the origin, development and

maturation of erythrocytes from primitive stem cell
• Stem cells are the primary cells capable of
1.self-renewal
2.differentiating into specialized cells
INTRODUCTION
• Hemopoietic stem cells are the primitive cells in the bone marrow,
which give rise to the blood cells.
• Hemopoietic stem cells in the bone marrow are called uncommitted

pluripotent hemopoietic stem cells ( PHSC).
• PHSC is defined as a cell that can give rise to all types of blood cells.
• They differentiate into one or another type of committed stem cells

INTRODUCTION (progenitor cells).
• Committed PHSC – these cells are restricted to give rise to one group
of blood cells.
PROCESS OF
ERYTHROPOIESIS
• Committed PHSC are of two
types:
• Lymphoid Stem Cells – It gives rise

to lymphocytes and natural killer
cells.
• Colony forming unit - gives rise to

myeloid cells (CFU-GEMM)
• A committed stem cell that
forms erythrocytes is called
colony forming unit
erythrocytes. CFU-E
COLONY FORMING Responds to other
stimulus forms
Highly sensitive
UNIT – E Colony forming
and dependent on
erythropoietin
unit CFU –E
GROWTH FACTORS
• Granulocyte-Monocyte colony stimulating
factor (CSF-MG)- a myeloid growth factor
that stimulates erythroid , granulocyte ,
monocyte , megakaryocyte , eosinophil
progenitor
• Insulin like growth factor (IGF1)

• Stem cell factor (SCF)
• Interleukin 3 (IL-3)
ERYTHROPOITEIN
• It is a hormone produced
primarily by the kidneys. It plays a
key role in the production of red
blood cells (RBCs)
• It stimulates proliferation , growth

and differentiation of erythroid
precursor
Mechanism Of Erythropoietin
• Early release of reticulocyte
• Inhibition of Apoptosis
• Reduce the bone marrow transit time
• Cells of CFU – E pass through different stages and finally become the
matured RBCs, during these stages four important changes are noticed.
CHANGES 1.Reduction in size of the cell
DURING 2.Disappearance of nucleoli and nucleus.
ERYTHROPOIESIS 3. Appearance of hemoglobin.
4.Change in the staining properties of the cytoplasm
PROCESS OF ERYTHROPOIESIS
1) Pronormoblast
✓ earliest recognizable erythroid precursor

✓ high nucleus to cytoplasm ratio
✓ uniform chromatin pattern that is
somewhat more distinct
✓ Blue cytoplasm, intensely stained .
✓ Begins to accumulate component for
hemoglobin production
✓ It undergoes mitosis (capable of cell
division )
✓ Present only in bone marrow
2) Basophilic
Normoblast
• Nucleoli are present but are not

often visible
• (N/C) ratio decrease (6:1)
• cytoplasm is deeply basophilic
• Chromatin beings to condense
• Capable of cell division & present
only in BM
• Detectable Hb synthesis occurs
,1st cell capable of Hb synthesis )
3) Polychromatophilic
normoblast
• slightly smaller than the

basophilic normoblast
• nucleus occupies about half of
the area of the cell (4:1)
• Blue greyish to pink grey
cytoplasm
• the nucleus becomes small and
dense (pyknotic)
• Last cell capable of mitosis
4) Orthochromatic
normoblast
• Completely condensed nucleus

(non functional )
• The cytoplasm contains more
abundant hemoglobin and fewer
polyribosome
• Cytoplasm appears pink b/c its
fully hemoglobinized
• Not capable of cell division cause
chromatin is condensed
• Nucles is ejected
• Howell-jolly bodies
5) Polychromatophilic
erythroblast
(reticulocyte)
• the reticulocyte is
polychromatophilic as a result of
the retention of RNA.
• It only stains with supravital
stain , Romanowsky stain.
• Has no nucleus
• Completes the reproduction oh
Hb
• Stays 1-2 day in BM and 1 day
in circulation
• They are the earliest blood cells
in the lineage of erythropoiesis
series that are seen normal in
blood circulation
• Biconcave disc shape ( allows
optimal gas exchange)
• non nucleated
• Appear salmon pink with central
6) Erythrocytes pallor
• Membrane is flexible and
deformable that allows them to
squeeze through blood vessels
• circulate for about 120 days
SUMMARY
SITE OF
ERYTHROPOIESIS
A) IN FETAL LIFE Erythropoiesis

occurs in three stages
1. Mesoblastic Stage
✓ during the first 2 months of
intrauterine life
✓ the RBCs are produced from
mesenchyme of yolk sac.
✓ Occurs intravascularly
✓ Development of primitive
erythroblast
SITE
OF ERYTHROPOIESIS
• 2.Hepatic Stage
✓ from third month of intra-

uterine life, liver is the main
organ that produces RBCs.
Spleen and Lymphoid organs are
also involved in erythropoiesis.
3.Myeloid Stage
SITE OF
ERYTHROPOIESIS ✓during the last three months of intrauterine life, the
RBCs are produced from the red bone marrow and liver.
SITE OF
ERYTHROPOIESIS
B) NEW BORN BABIES & CHILDREN

✓ Up to the Age of 20 Years: RBCs are
produced from the red bone marrow of
all the bones (long bones and flat
bones).
• C)After the Age of 20 Years

✓ RBCs are produced from membranous
bones like vertebrae, sternum, ribs,
scapula, iliac bones and skull bones
and from the end of long bones.
Hemoglobin/Erythrocyte
Breakdown
1. Intravascular hemolysis (10%)
a. abnormal cause leading to premature death of RBC
b. hemoglobin breaks down in the blood and free
hemoglobin is released into plasma
c. Free hemoglobin binds to haptoglobin (major free

hemoglobin transport protein), hemopexin, and albumin,
and it is phagocytized by liver macrophages.
2. Extravascular
hemolysis (90%)
a. Occurs when senescent/old RBCs are

phagocytized by macrophages in
the spleen
b. Protoporphyrin ring metabolized to

bilirubin and urobilinogen; excreted in urine
and feces
c. Globin chains are recycled into the amino
acid pool for protein synthesis.
d. Iron binds to transferrin and is
transported to bone marrow for new RBC
production, or it is stored for future use in
the form of ferritin or hemosiderin.
THE END
THANK YOU :)

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By : IBRAHIM ,

RIMAN MUSTAFA ERYTHROPOIESIS

INTRODUCTION • Hemopoiesis or Hematopoiesis is the process of origin,

• Erythropoiesis is the process of the origin, development and

• Hemopoietic stem cells in the bone marrow are called uncommitted

• They differentiate into one or another type of committed stem cells

• Lymphoid Stem Cells – It gives rise

• Colony forming unit - gives rise to

• Insulin like growth factor (IGF1)

• It stimulates proliferation , growth

✓ earliest recognizable erythroid precursor

• Nucleoli are present but are not

• slightly smaller than the

• Completely condensed nucleus

A) IN FETAL LIFE Erythropoiesis

✓ from third month of intra-

B) NEW BORN BABIES & CHILDREN

• C)After the Age of 20 Years

c. Free hemoglobin binds to haptoglobin (major free

a. Occurs when senescent/old RBCs are

b. Protoporphyrin ring metabolized to

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