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LEUKEMIAS

Blood and Lymph Systems Basics

To understand the different types of leukemia, here are some basics about the blood and lymph systems.

Bone Marrow

Bone marrow is the soft inner part of some bones such as the skull, shoulder blades, ribs, pelvis, and backbones. The bone marrow is made up of a small number of blood stem cells, more mature blood-forming cells, fat cells, and supporting tissues that help cells grow.

 

Blood stem cells go through a series of changes to make new blood cells. During this process, the cells develop into either lymphocytes (a kind of white blood cell) or other blood-forming cells. The other blood-forming cells can develop into 1 of the 3 main types of blood cell components:

  • Red blood cells
  • Platelets
  • White blood cells (other than lymphocytes)

Red Blood Cells

Red blood cells carry oxygen from the lungs to all other tissues in the body, and take carbon dioxide back to the lungs to be removed. Anemia (having too few red blood cells in the body) typically causes a person to feel tired, weak, and short of breath because the body tissues are not getting enough oxygen.

Platelets

Platelets are actually cell fragments made by a type of bone marrow cell called the megakaryocyte. Platelets are important in plugging up holes in blood vessels caused by cuts or bruises. A shortage of platelets is called thrombocytopenia. A person with thrombocytopenia may bleed and bruise easily.

White Blood Cells

White blood cells help the body fight infections. Lymphocytes are one type of white blood cell. The other types of white blood cells are granulocytes (neutrophils, basophils, and eosinophils) and monocytes. These other types are known as myeloid cells.

Lymphocytes

These are the main cells that make up lymphoid tissue, a major part of the immune system. Lymphoid tissue is found in lymph nodes, the thymus gland, the spleen, the tonsils and adenoids, and is scattered throughout the digestive and respiratory systems and the bone marrow.

Lymphocytes develop from cells called lymphoblasts and become mature, infection-fighting cells. The 2 main types of lymphocytes are known as B lymphocytes (B cells) and T lymphocytes (T cells).

  • B lymphocytes protect the body from invading germs by developing (maturing) into plasma cells, which make proteins called antibodies. The antibodies attach to the germs (bacteria, viruses, and fungi), which helps other white blood cells to recognize and destroy them.
  • T lymphocytes can recognize cells infected by viruses and directly destroy these cells. They also help regulate the immune response.

Granulocytes

These are white blood cells that have granules in them that can be seen under the microscope as spots. These granules contain enzymes and other substances that can destroy germs, such as bacteria.

The 3 types of granulocytes – neutrophils, basophils, and eosinophils – are distinguished by the size and color of their granules. Granulocytes develop from blood-forming cells called myeloblasts to become mature, infection-fighting cells.

Monocytes

These white blood cells, which are related to granulocytes, also are important in protecting the body against bacteria. They start in the bone marrow as blood-forming monoblasts and develop into mature monocytes. After circulating in the bloodstream for about a day, monocytes enter body tissues to become macrophages, which can destroy some germs by surrounding and digesting them. Macrophages also help lymphocytes recognize germs and start making antibodies to fight them.

Any of the blood-forming or lymphoid cells from bone marrow can turn into a leukemia cell. Once this change takes place, the leukemia cells fail to go through their normal process of maturing. Leukemia cells may reproduce quickly, but in most cases the problem is that they don’t die when they should. They survive and build up in the bone marrow. Over time, these cells spill into the bloodstream and spread to other organs, where they can keep other cells in the body from functioning normally.