Chronic myeloid leukemia is a slow-growing cancer of the blood-forming tissue (bone marrow), in which too many white blood cells are made. It usually affects older adults and rarely occurs in children. The condition consists of three phases: the chronic phase, the accelerated phase, and the blast phase. Learn about symptoms, genetics, and treatment.
LMC5
Image by J3D3/Wikimedia
About
К562 cell
Image by Антоненко Світлана/Wikimedia
К562 cell
Blood cells of patients with chronic myeloid leukemia. 1,2 - fluorescent microscopy (100CH) 3 - light microscopy (100H).
Image by Антоненко Світлана/Wikimedia
What Is Chronic Myelogenous Leukemia?
Chronic myelogenous leukemia is a disease in which the bone marrow makes too many white blood cells.
Chronic myelogenous leukemia (also called CML or chronic granulocytic leukemia) is a slowly progressing blood and bone marrow disease that usually occurs during or after middle age, and rarely occurs in children.
Anatomy of the bone. The bone is made up of compact bone, spongy bone, and bone marrow. Compact bone makes up the outer layer of the bone. Spongy bone is found mostly at the ends of bones and contains red marrow. Bone marrow is found in the center of most bones and has many blood vessels. There are two types of bone marrow: red and yellow. Red marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Yellow marrow is made mostly of fat.
Leukemia may affect red blood cells, white blood cells, and platelets.
Normally, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. A lymphoid stem cell becomes a white blood cell.
A myeloid stem cell becomes one of three types of mature blood cells:
Red blood cells that carry oxygen and other substances to all tissues of the body.
Platelets that form blood clots to stop bleeding.
Granulocytes (white blood cells) that fight infection and disease.
Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell.
In CML, too many blood stem cells become a type of white blood cell called granulocytes. These granulocytes are abnormal and do not become healthy white blood cells. They are also called leukemia cells. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. When this happens, infection, anemia, or easy bleeding may occur.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (16)
What is Chronic myeloid leukemia?
Video by XpertDox/YouTube
Blood cells of patients with chronic myeloid leukemia. Fluorescent microscopy (100Ð¥)
Blood cells of patients with chronic myeloid leukemia. Fluorescent microscopy (100Х)
Image by Svetlana
Fluorescence in situ hybridization (FISH) image of bcr/abl positive rearranged metaphase
FISH method. The chromosomes are blue in the fluorescence microscope , except for a point on one of the chromosomes, which is green and red. This is where the sequence causing one of the types of leukemia is located
Image by Pmx
Diagram showing which cells CML can start in
Diagram showing which cells CML can start in
Image by Cancer Research UK / Wikimedia Commons
Chronic Myeloid Leukemia (CML) | Pathogenesis, Symptoms and Treatment
Video by JJ Medicine/YouTube
Resistant Chronic Myeloid Leukemia
Video by Leukemia & Lymphoma Society/YouTube
Chronic Myeloid Leukemia: A Patient's Journey
Video by American Society of Hematology/YouTube
Understanding Chronic Myeloid Leukemia - Jumo Health
Video by Jumo Health/YouTube
Chronic Myeloid Leukemia (CML): What are CML milestones?
Video by Leukemia & Lymphoma Society/YouTube
Chronic Myeloid Leukemia (CML): What to do if I experience side effects?
Video by Leukemia & Lymphoma Society/YouTube
Chronic Myeloid Leukemia
Video by Lee Health/YouTube
Blast Crisis in CML | When Chronic Myeloid Leukemia Goes Mad!
Video by Medicosis Perfectionalis/YouTube
Chronic Myeloid Leukemia (CML) | A Myeloproliferative Neoplasm (MPN) | Philadelphia Chromosome
Video by Medicosis Perfectionalis/YouTube
New trends in the management of leukemia
Video by VJHemOnc – Video Journal of Hematological Oncology/YouTube
CML - Animation
Video by CaptainWhaler/YouTube
Dr. Erba Describes Proper Diagnostic Testing of CML
Video by OncLiveTV/YouTube
4:32
What is Chronic myeloid leukemia?
XpertDox/YouTube
Blood cells of patients with chronic myeloid leukemia. Fluorescent microscopy (100Ð¥)
Svetlana
Fluorescence in situ hybridization (FISH) image of bcr/abl positive rearranged metaphase
Pmx
Diagram showing which cells CML can start in
Cancer Research UK / Wikimedia Commons
10:22
Chronic Myeloid Leukemia (CML) | Pathogenesis, Symptoms and Treatment
JJ Medicine/YouTube
14:47
Resistant Chronic Myeloid Leukemia
Leukemia & Lymphoma Society/YouTube
4:11
Chronic Myeloid Leukemia: A Patient's Journey
American Society of Hematology/YouTube
10:59
Understanding Chronic Myeloid Leukemia - Jumo Health
Jumo Health/YouTube
2:46
Chronic Myeloid Leukemia (CML): What are CML milestones?
Leukemia & Lymphoma Society/YouTube
1:17
Chronic Myeloid Leukemia (CML): What to do if I experience side effects?
Leukemia & Lymphoma Society/YouTube
1:45
Chronic Myeloid Leukemia
Lee Health/YouTube
5:14
Blast Crisis in CML | When Chronic Myeloid Leukemia Goes Mad!
Medicosis Perfectionalis/YouTube
17:59
Chronic Myeloid Leukemia (CML) | A Myeloproliferative Neoplasm (MPN) | Philadelphia Chromosome
Medicosis Perfectionalis/YouTube
2:29
New trends in the management of leukemia
VJHemOnc – Video Journal of Hematological Oncology/YouTube
5:21
CML - Animation
CaptainWhaler/YouTube
2:39
Dr. Erba Describes Proper Diagnostic Testing of CML
OncLiveTV/YouTube
Causes
Schematic of the Philadelphia Chromosome
Image by Aryn89
Schematic of the Philadelphia Chromosome
Schematic of the Philadelphia Chromosome
Image by Aryn89
What Causes Chronic Myelogenous Leukemia?
Most people with CML have a gene mutation (change) called the Philadelphia chromosome.
Every cell in the body contains DNA (genetic material) that determines how the cell looks and acts. DNA is contained inside chromosomes. In CML, part of the DNA from one chromosome moves to another chromosome. This change is called the “Philadelphia chromosome.” It results in the bone marrow making a protein, called tyrosine kinase, that causes too many stem cells to become white blood cells (granulocytes or blasts).
The Philadelphia chromosome is not passed from parent to child.
The Philadelphia (Ph) chromosome is an abnormal chromosome that is made when pieces of chromosomes 9 and 22 break off and trade places. The ABL gene from chromosome 9 joins to the BCR gene on chromosome 22 to form the BCR::ABL fusion gene. The changed chromosome 22 with the fusion gene on it is called the Ph chromosome.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (4)
Philadelphia Chromosome
Philadelphia Chromosome Translocation
Image by A Obeidat in ar.wikipedia
New findings on the Philadelphia chromosome
Video by UF Health/YouTube
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
CML - Animation
Video by CaptainWhaler/YouTube
Philadelphia Chromosome
A Obeidat in ar.wikipedia
4:15
New findings on the Philadelphia chromosome
UF Health/YouTube
9:50
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
5:21
CML - Animation
CaptainWhaler/YouTube
ABL1 Gene
Ideogram of human chromosome 9
Image by Office of Biological and Environmental Research of the U.S. Department of Energy Office of Science, the Biological and Environmental Research Information System, Oak Ridge National Laboratory.
Ideogram of human chromosome 9
Selected genes, traits, and disorders associated with the chromosome listed; (blue and violet) regions reflecting the unique patterns of light and dark bands seen on human chromosomes stained to allow viewing through a light microscope; (red) the centromere, or constricted portion, of each chromosome; (yellow) chromosomal regions that vary in staining intensity and sometimes are called hererochromatin (meaning “different color”); (lines between yellow) variable regions, called stalks, that connect a very small chromosome arm (a “satellite”) to the chromosome.
Image by Office of Biological and Environmental Research of the U.S. Department of Energy Office of Science, the Biological and Environmental Research Information System, Oak Ridge National Laboratory.
The ABL1 gene provides instructions for making a protein involved in many processes in cells throughout the body. The ABL1 protein functions as a kinase, which is an enzyme that changes the activity of other proteins by adding a cluster of oxygen and phosphorus atoms (a phosphate group) at specific positions. The ABL1 kinase is normally turned off (inactive) and must be turned on (activated) to perform its functions.
The ABL1 kinase can be turned on by a number of different triggers and can add a phosphate group to many different proteins (also called substrates). This diversity allows ABL1 to be involved in a wide variety of cellular processes, including cell growth and division (proliferation), maturation (differentiation), and movement (migration). It can either aid in cell survival or trigger controlled cell death (apoptosis), depending on cellular conditions. The ABL1 kinase interacts with several proteins involved in the network of fibers called the actin cytoskeleton, which makes up the structural framework inside cells. These interactions help control cell migration and the attachment of cells to one another (adhesion), among many other processes. ABL1 can also help regulate the activity of other genes.
The ABL1 gene belongs to a class of genes known as oncogenes. When mutated, oncogenes have the potential to cause normal cells to become cancerous.
Health Conditions Related to Genetic Changes
Chronic myeloid leukemia
A genetic rearrangement (translocation) involving the ABL1 gene causes a type of cancer of blood-forming cells called chronic myeloid leukemia. This slow-growing cancer leads to an overproduction of abnormal white blood cells. Common features of the condition include excessive tiredness (fatigue), fever, weight loss, and an enlarged spleen.
The translocation involved in this condition, written as t(9;22), fuses part of the ABL1 gene from chromosome 9 with part of the BCR gene from chromosome 22, creating an abnormal fusion gene called BCR-ABL1. The abnormal chromosome 22, containing a piece of chromosome 9 and the BCR-ABL1 fusion gene, is commonly called the Philadelphia chromosome. The translocation is acquired during a person's lifetime and is present only in the abnormal blood cells. This type of genetic change, called a somatic mutation, is not inherited.
The protein produced from the abnormal fusion gene, called BCR-ABL1, functions as a kinase. However, unlike the ABL1 kinase, it does not require signals in the cell to turn it on. The constantly active BCR-ABL1 protein signals cells to continue dividing abnormally and prevents them from self-destructing, which leads to overproduction of the abnormal cells.
The presence of the Philadelphia chromosome provides a target for molecular therapies.
Other cancers
The BCR-ABL1 fusion gene (described above) is also involved in fast-growing blood cell cancers called acute leukemias. It has been found in 5 percent of children and up to 30 percent of adults with B-cell acute lymphoblastic leukemia and very rarely in acute myeloid leukemia. As in chronic myeloid leukemia, the BCR-ABL1 protein stimulates overproduction of abnormal white blood cells, leading to cancer. It is likely that the form of blood cancer that develops is influenced by the type of blood cell that acquires the mutation and other genetic changes that occur.
Rarely, translocations that lead to fusion of the ABL1 gene with genes other than BCR are associated with acute leukemias. For example, the ETV6-ABL1 fusion gene has been found in a small number of cases of B-cell acute lymphoid leukemia, and a chronic leukemia that can resemble chronic myeloid leukemia. The exact mechanisms by which these rare fusion genes lead to blood cancer are not completely understood, although it is likely that the proteins produced from them promote uncontrolled growth of cells.
Image by Office of Biological and Environmental Research of the U.S. Department of Energy Office of Science, the Biological and Environmental Research Information System, Oak Ridge National Laboratory.
Ideogram of human chromosome 22
Selected genes, traits, and disorders associated with the chromosome listed; (blue and violet) regions reflecting the unique patterns of light and dark bands seen on human chromosomes stained to allow viewing through a light microscope; (red) the centromere, or constricted portion, of each chromosome; (yellow) chromosomal regions that vary in staining intensity and sometimes are called hererochromatin (meaning “different color”); (lines between yellow) variable regions, called stalks, that connect a very small chromosome arm (a “satellite”) to the chromosome.
Image by Office of Biological and Environmental Research of the U.S. Department of Energy Office of Science, the Biological and Environmental Research Information System, Oak Ridge National Laboratory.
BCR Gene: BCR Activator of RhoGEF and GTPase
Normal Function
The BCR gene provides instructions for making a protein whose function is not completely understood. Studies show that the BCR protein may act as a GTPase activating protein (GAP). GAPs turn off (inactivate) proteins called GTPases, which play an important role in chemical signaling within cells. Often referred to as molecular switches, GTPases can be turned on and off. They are turned on (active) when they are attached (bound) to a molecule called GTP and are turned off when they are bound to another molecule called GDP. The BCR protein inactivates a GTPase known as Rac1 by stimulating a reaction that turns the attached GTP into GDP. Through this activity, the BCR protein helps regulate the movement (migration) and function of cells.
The BCR protein can also act as a kinase, which is an enzyme that changes the activity of other proteins by adding a cluster of oxygen and phosphorus atoms (a phosphate group) at specific positions. BCR's kinase activity is likely involved in regulating signaling within cells, although its exact role is unclear.
Health Conditions Related to Genetic Changes
Chronic myeloid leukemia
A genetic rearrangement (translocation) involving the BCR gene causes a type of cancer of blood-forming cells called chronic myeloid leukemia. This slow-growing cancer leads to an overproduction of abnormal white blood cells. Common features of the condition include excessive tiredness (fatigue), fever, weight loss, and an enlarged spleen.
The translocation involved in this condition, written as t(9;22), fuses part of the ABL1 gene from chromosome 9 with part of the BCR gene from chromosome 22, creating an abnormal fusion gene called BCR-ABL1. The abnormal chromosome 22, containing a piece of chromosome 9 and the BCR-ABL1 fusion gene, is commonly called the Philadelphia chromosome. The translocation is acquired during a person's lifetime and is present only in the abnormal blood cells. This type of genetic change, called a somatic mutation, is not inherited.
The protein produced from the abnormal fusion gene, called BCR-ABL1, signals for cells to grow and divide and blocks the self-destruction of cells that are abnormal or unneeded. The BCR-ABL1 protein is always turned on, so growth and division of affected blood cells is uncontrolled, leading to overproduction of the abnormal cells.
The presence of the Philadelphia chromosome provides a target for molecular therapies.
Other cancers
The BCR-ABL1 fusion gene (described above) is also involved in fast-growing blood cell cancers called acute leukemias. It has been found in 5 percent of children and up to 30 percent of adults with B-cell acute lymphoblastic leukemia and very rarely in acute myeloid leukemia. As in chronic myeloid leukemia, the BCR-ABL1 protein stimulates overproduction of abnormal white blood cells, leading to cancer. It is likely that the form of blood cancer that develops is influenced by the type of blood cell that acquires the mutation and other genetic changes that occur.
Other Names for This Gene
ALL
BCR/FGFR1 chimera protein
BCR1
breakpoint cluster region
breakpoint cluster region protein isoform 1
breakpoint cluster region protein isoform 2
CML
D22S11
D22S662
FGFR1/BCR chimera protein
PHL
renal carcinoma antigen NY-REN-26
Genomic Location
The BCR gene is found on chromosome 22.
Source: MedlinePlus Genetics
Symptoms
Fatigue
Image by TheVisualMD
Fatigue
Fatigue
Image by TheVisualMD
What Are the Signs and Symptoms of Chronic Myelogenous Leukemia?
Signs and symptoms of chronic myelogenous leukemia include weight loss and tiredness.
These and other signs and symptoms may be caused by CML or by other conditions. Check with your doctor if you have any of the following:
Feeling very tired.
Weight loss for no known reason.
Drenching night sweats.
Fever.
Pain or a feeling of fullness below the ribs on the left side.
Sometimes CML does not cause any symptoms at all.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (3)
Fatigue
The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. (NCBI/NLM/NIH)
Image by TheVisualMD
Chronic Myeloid Leukemia (CML) | Pathogenesis, Symptoms and Treatment
Video by JJ Medicine/YouTube
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Fatigue
TheVisualMD
10:22
Chronic Myeloid Leukemia (CML) | Pathogenesis, Symptoms and Treatment
JJ Medicine/YouTube
9:50
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
Diagnosis
Cancer Screening
Image by TheVisualMD
Cancer Screening
Screening for Cancer: Blood Tests : Blood tests can help detect cancer, but additional tests are necessary to confirm diagnosis. A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle, or via fingerprick. Examples of blood tests used to diagnose cancer include Complete Blood Count (CBC) which measures the amount of various types of blood cells and detects if there are too many or too few of a type of blood cell or abnormal cells; and Blood Protein Testing which is a test to examine various proteins in blood (electrophoresis) that can aid in detecting certain abnormal immune system proteins (immunoglobulins) that are sometimes elevated in people with multiple myeloma.
Image by TheVisualMD
How Is Chronic Myelogenous Leukemia Diagnosed?
Tests that examine the blood and bone marrow are used to diagnose chronic myelogenous leukemia.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease such as an enlarged spleen. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Complete blood count (CBC) with differential: A procedure in which a sample of blood is drawn and checked for the following:
The number of red blood cells and platelets.
The number and type of white blood cells.
The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
The portion of the blood sample made up of red blood cells.
Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for abnormal cells. Bone marrow aspiration and biopsy. After a small area of skin is numbed, a bone marrow needle is inserted into the patient’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.
One of the following tests may be done on the samples of blood or bone marrow tissue that are removed:
Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of blood or bone marrow are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes, such as the Philadelphia chromosome, may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
FISH (fluorescence in situ hybridization): A laboratory test used to look at and count genes or chromosomes in cells and tissues. Pieces of DNA that contain fluorescent dyes are made in the laboratory and added to a sample of a patient’s cells or tissues. When these dyed pieces of DNA attach to certain genes or areas of chromosomes in the sample, they light up when viewed under a fluorescent microscope. The FISH test is used to help diagnose cancer and help plan treatment.
Reverse transcription–polymerase chain reaction test (RT–PCR): A laboratory test in which the amount of a genetic substance called mRNA made by a specific gene is measured. An enzyme called reverse transcriptase is used to convert a specific piece of RNA into a matching piece of DNA, which can be amplified (made in large numbers) by another enzyme called DNA polymerase. The amplified DNA copies help tell whether a specific mRNA is being made by a gene. RT-PCR can be used to check the activation of certain genes that may indicate the presence of cancer cells. This test may be used to look for certain changes in a gene or chromosome, which may help diagnose cancer.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (5)
Complete blood count and differential
Illustration of complete blood count and differential (hemogram, full blood exam, leukogram etc.) test results with blood specimen in EDTA tube. N.B. these are my own CBC and diff results so no patient confidentiality issues. Symbol key: CBC, complete blood cell count; WBC, white blood cell count (leukocyte count); RBC, red blood cell count (erythrocyte count); HGB, hemoglobin level; HCT, hematocrit; MCV, mean corpuscular volume; MCH, mean corpuscular hemoglobin (per erythrocyte); MCHC, mean corpuscular hemoglobin concentration; RDW-CV, red blood cell distribution width–coefficient of variation; PLT, platelet count (thrombocyte count); MPV, mean platelet volume; NEUT, neutrophil count; LYMPH, lymphocyte count; MONO, monocyte count; EO, eosinophil count; BASO, basophil count; IG, immature granulocyte count; NRBC, nucleated red blood cell count; EDTA, ethylenediaminetetraacetic acid, a preservative that makes the blood sample last long enough to be processed (it inhibits coagulation by chelating calcium ions).
Image by SpicyMilkBoy/Wikimedia
Reverse transcription polymerase chain reaction
SVGified overview of rt-PCR technique
Image by Poshul/Wikimedia
RT PCR Model
Reverse Transcription - PCR
cDNA Synthesis from mRNA by using M-MuLV reverse transcriptase and cDNA Amplification with specific primers by using Taq Polymerase
Image by Lokeshthimmana/Wikimedia
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Chronic Myeloid Leukemia
Video by Lee Health/YouTube
Complete blood count and differential
SpicyMilkBoy/Wikimedia
Reverse transcription polymerase chain reaction
Poshul/Wikimedia
RT PCR Model
Lokeshthimmana/Wikimedia
9:50
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
1:45
Chronic Myeloid Leukemia
Lee Health/YouTube
FISH
Fluorescence In Situ Hybridization (FISH)
Image by National Human Genome Research Institute (NHGRI)
Fluorescence In Situ Hybridization (FISH)
Image by National Human Genome Research Institute (NHGRI)
Fluorescence In Situ Hybridization (FISH)
What is FISH?
Fluorescence in situ hybridization (FISH) provides researchers with a way to visualize and map the genetic material in an individual's cells, including specific genes or portions of genes. This may be used for understanding a variety of chromosomal abnormalities and other genetic mutations.
How does FISH work?
FISH is useful, for example, to help a researcher or clinician identify where a particular gene falls within an individual's chromosomes. The first step is to prepare short sequences of single-stranded DNA that match a portion of the gene the researcher is looking for. These are called probes. The next step is to label these probes by attaching one of a number of colors of fluorescent dye.
DNA is composed of two strands of complementary molecules that bind to each other like chemical magnets. Since the researchers' probes are single-stranded, they are able to bind to the complementary strand of DNA, wherever it may reside on a person's chromosomes. When a probe binds to a chromosome, its fluorescent tag provides a way for researchers to see its location.
What is FISH used for?
Scientists use three different types of FISH probes, each of which has a different application:
Locus specific probes bind to a particular region of a chromosome. This type of probe is useful when scientists have isolated a small portion of a gene and want to determine on which chromosome the gene is located, or how many copies of a gene exist within a particular genome.
Alphoid or centromeric repeat probes are generated from repetitive sequences found in the middle of each chromosome. Researchers use these probes to determine whether an individual has the correct number of chromosomes. These probes can also be used in combination with "locus specific probes" to determine whether an individual is missing genetic material from a particular chromosome.
Whole chromosome probes are actually collections of smaller probes, each of which binds to a different sequence along the length of a given chromosome. Using multiple probes labeled with a mixture of different fluorescent dyes, scientists are able to label each chromosome in its own unique color. The resulting full-color map of the chromosome is known as a spectral karyotype. Whole chromosome probes are particularly useful for examining chromosomal abnormalities, for example, when a piece of one chromosome is attached to the end of another chromosome.
For many applications, FISH has largely been replaced by the use of microarrays. However, FISH remains useful for some tests. FISH may also be used to study comparisons among the chromosomal arrangements of genes across related species.
Source: National Human Genome Research Institute (NHGRI)
Additional Materials (3)
Fluorescence in Situ Hybridization (FISH)
Video by Leukemia & Lymphoma Society/YouTube
FISH Technique Fluorescent In Situ Hybridization HD Animation 1
Video by ПИМУ - Приволжский исследовательский мед.универ./YouTube
Fluorescence In Situ Hybridization (FISH)
Video by Abnova/YouTube
3:22
Fluorescence in Situ Hybridization (FISH)
Leukemia & Lymphoma Society/YouTube
1:44
FISH Technique Fluorescent In Situ Hybridization HD Animation 1
PCR (polymerase chain reaction) tests identify genetic material in a sample to diagnose an infectious disease or a genetic condition. PCR tests are also used to detect cancer and monitor response to treatment. The tests are fast and highly accurate.
PCR (polymerase chain reaction) tests identify genetic material in a sample to diagnose an infectious disease or a genetic condition. PCR tests are also used to detect cancer and monitor response to treatment. The tests are fast and highly accurate.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative PCR result means that the DNA or RNA of the pathogen (disease-causing organism) or abnormal cells where not found in your sample.
Related conditions
PCR (polymerase chain reaction) tests are a fast, highly accurate way to diagnose certain infectious diseases and genetic changes. The tests work by finding the DNA or RNA of a pathogen (disease-causing organism) or abnormal cells in a sample.
DNA is the genetic material that contains instructions and information for all living things.
RNA is another type of genetic material. It contains information that has been copied from DNA and is involved in making proteins.
Most viruses and other pathogens contain DNA or RNA.
Unlike many other tests, PCR tests can find evidence of disease in the earliest stages of infection. Other tests may miss early signs of disease because there aren't enough viruses, bacteria, or other pathogens in the sample, or your body hasn't had enough time to develop an antibody response. Antibodies are proteins made by your immune system to attack foreign substances, such as viruses and bacteria. PCR tests can detect disease when there is only a very small amount of pathogens in your body.
During a PCR test, a small amount of genetic material in a sample is copied multiple times. The copying process is known as amplification. If there are pathogens in the sample, amplification will make them much easier to see.
PCR tests are used to:
Diagnose certain infectious diseases
Identify a genetic change that can cause disease
Find small amounts of cancer cells that might be missed in other types of tests
PCR tests work by:
Taking a sample of blood, saliva, mucus, or tissue
The sample will contain your own DNA and possibly the DNA of a pathogen or cancer cell.
The sample is put in a special machine. An enzyme called polymerase is added to the sample. This causes the sample to produce copies.
The copying process is repeated multiple times. After about an hour, billions of copies are made. If a virus or pathogen is present, it will be indicated on the machine.
Certain viruses, including COVID-19, are made up of RNA rather than DNA. For these viruses, the RNA must be changed into DNA before copying. This process is called reverse transcription PCR (rtPCR).
PCR and rtPCR check for the presence of a pathogen. Another type of PCR known as quantitative PCR (qPCR) measures the amount of pathogens in the sample. qPCR can be done at the same time as PCR or rtPCR.
There are different ways to get a sample for a PCR test. Common methods include blood tests and nasal swabs.
During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
A nasal swab may be taken from the front part of your nostrils (anterior nares). It also may be taken from the back of your nostrils, in a procedure known as a nasal mid-turbinate (NMT) swab, or from the nasopharynx, the uppermost part of your nose and throat. In some cases, a health care provider will ask you to do an anterior nares test or an NMT swab yourself.
During an anterior nares test, you will start by tilting your head back. Then you or the provider will:
Gently insert a swab inside your nostril
Rotate the swab and leave it in place for 10 to 15 seconds
Remove the swab and insert it into your second nostril
Swab the second nostril using the same technique
Remove the swab
During an NMT swab, you will start by tilting your head back. Then you or your provider will:
Gently insert a swab onto the bottom of the nostril, pushing it until you feel it stopping
Rotate the swab for 15 seconds
Remove the swab and insert it into your second nostril
Swab the second nostril using the same technique
Remove the swab
During a nasopharyngeal swab:
You will tip your head back.
Your health care provider will insert a swab into your nostril until it reaches your nasopharynx (the upper part of your throat).
Your provider will rotate the swab and remove it.
You don't need any special preparations for a PCR test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
A nasal swab may tickle your throat or cause you to cough. A nasopharyngeal swab may be uncomfortable and cause coughing or gagging. All these effects are temporary.
PCR tests are an accurate and reliable method for identifying many infectious diseases. And because they are often able to make diagnoses before symptoms of infection occur, PCR tests play a crucial role in preventing the spread of diseases.
PCR Tests: MedlinePlus Medical Test [accessed on Jan 05, 2022]
NCI Dictionary of Cancer Terms [accessed on Jan 05, 2022]
Laboratory Methods - Testing.com [accessed on Feb 18, 2022]
Blood Work | How This Provides Clues On Your Health | Leukemia & Lymphoma Society® (LLS) [accessed on Jan 05, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (31)
Polymerase Chain Reaction (PCR)
Polymerase chain reaction (PCR) is a technique used to "amplify" small segments of DNA.
Image by National Human Genome Research Institute (NHGRI)
Biotechnology
Polymerase chain reaction, or PCR, is used to amplify a specific sequence of DNA. Primers—short pieces of DNA complementary to each end of the target sequence—are combined with genomic DNA, Taq polymerase, and deoxynucleotides. Taq polymerase is a DNA polymerase isolated from the thermostable bacterium Thermus aquaticus that is able to withstand the high temperatures used in PCR. Thermus aquaticus grows in the Lower Geyser Basin of Yellowstone National Park. Reverse transcriptase PCR (RT-PCR) is similar to PCR, but cDNA is made from an RNA template before PCR begins.
Image by CNX Openstax
Antigenic Shift
Illustration of antigenic shift. NIAID illustration of potential influenza genetic reassortment
Image by National Institute of Allergy and Infectious Diseases (NIAID)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory
Microcentrifuge tubes in a rack. Some of them are DNA samples while the remainder of them are primers to be used in polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Pipette
National Cancer Institute researcher pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Polymerase chain reaction (PCR)
Video by khanacademymedicine/YouTube
Polymerase Chain Reaction (PCR)
Video by DNA Learning Center/YouTube
PCR tubes
Photo of a strip of PCR tubes, each tube contains a 1000uL (1mL) reaction.
Image by Madprime
What is Polymerase Chain Reaction? | PCR Explained
Video by 2 Minute Classroom/YouTube
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
DNA Genotyping and Sequencing
A technician loads samples into a digital PCR machine at the Cancer Genomics Research Laboratory, part of the National Cancer Institute's Division of Cancer Epidemiology and Genetics (DCEG). Polymerase chain reaction (PCR) is a technique that greatly amplifies small pieces of DNA, generating many thousands of copies of a particular DNA sequence.
See also https://dceg.cancer.gov/about/organization/programs-hgp/cgr.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
National Cancer Institute researcher setting up genetic samples and primers for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Biotechnology
Southern blotting is used to find a particular sequence in a sample of DNA. DNA fragments are separated on a gel, transferred to a nylon membrane, and incubated with a DNA probe complementary to the sequence of interest. Northern blotting is similar to Southern blotting, but RNA is run on the gel instead of DNA. In western blotting, proteins are run on a gel and detected using antibodies.
Image by CNX Openstax
simple sequence repeat (SSR, a.k.a. microsatellite) locus
A number of DNA samples from specimens of Littorina plena amplified using polymerase chain reaction with primers targeting a variable simple sequence repeat (SSR, a.k.a. microsatellite) locus. Samples have been run on a 5% polyacrylamide gel and visualized using silver staining.
Image by ParinoidMarvin/Wikimedia
Biotechnology
This diagram shows the steps involved in molecular cloning.
Image by CNX Openstax
Gene therapy
Gene therapy using an adenovirus vector can be used to cure certain genetic diseases in which a person has a defective gene. (credit: NIH)
Image by U.S. National Library of Medicine
Testing for Ebola
Technicians set up polymerase chain reaction, or PCR, assay for Ebola in a containment laboratory. Assay components are assembled in the PCR hood to prevent contamination that could interfere with test results.
Image by U.S. Army photo by Dr. Randal J. Schoepp
reverse transcription polymerase chain reaction test
Microbiologist Erica Spackman reviews results of a reverse transcription polymerase chain reaction test to determine whether there is virus in a sample and to generate material for gene sequencing.
Image by USDA Agricultural Research Service/Photo by Suzanne Deblois.
How to Perform a Polymerase Chain Reaction | William Armour & Laura Towns
Oxford Academic (Oxford University Press)/YouTube
8:08
Gel Electrophoresis
Amoeba Sisters/YouTube
9:34
Polymerase chain reaction
Osmosis/YouTube
Polymerase Chain Reaction (PCR)
National Human Genome Research Institute (NHGRI)
Primer
National Human Genome Research Institute (NHGRI)
Complete Blood Count
Complete Blood Count
Also called: CBC, Full Blood Count, Blood Cell Count, Hemotology Panel
A complete blood count (CBC) is often part of a routine exam. It is used to measure different parts and features of your blood. A CBC can help detect a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers.
Complete Blood Count
Also called: CBC, Full Blood Count, Blood Cell Count, Hemotology Panel
A complete blood count (CBC) is often part of a routine exam. It is used to measure different parts and features of your blood. A CBC can help detect a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers.
A complete blood count, or CBC, is a blood test that measures many different parts and features of your blood, including:
Red blood cells, which carry oxygen from your lungs to the rest of your body.
White blood cells, which fight infections and other diseases. There are five major types of white blood cells. A CBC test measures the total number of white cells in your blood. A different test called a CBC with differential measures the number of each type of these white blood cells.
Platelets, which stop bleeding by helping your blood to clot.
Hemoglobin, a protein in red blood cells that carries oxygen from your lungs to the rest of your body.
Hematocrit, a measurement of how much of your blood is made up of red blood cells.
Mean corpuscular volume (MCV), a measure of the average size of your red blood cells.
Other names for a complete blood count: CBC, full blood count, blood cell count
A complete blood count is a common blood test that is often part of a routine checkup. Complete blood counts can help detect a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers.
Your health care provider may have ordered a complete blood count as part of your checkup or to monitor your overall health. The test may also be used to:
Help diagnose blood diseases, infection, immune system disorders, or other medical conditions
Check for changes in an existing blood disorder
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Usually there is no special preparation necessary for a complete blood count. But if your provider ordered other tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle went in, but most symptoms go away quickly.
A CBC counts the cells in your blood. There are many reasons your levels may not be in the normal range. For example:
Abnormal levels of red blood cells, hemoglobin, or hematocrit may be a sign of anemia, heart disease, or too little iron in your body.
Low white cell count may be a sign of an autoimmune disorder, bone marrow disorder, or cancer.
High white cell count may be a sign of an infection or a reaction to medicine.
If any of your levels are abnormal, it doesn't always mean you have a medical condition that needs treatment. Diet, activity level, medicines, a menstrual period, not drinking enough water, and other factors can affect the results. Talk with your provider to learn what your results mean.
A complete blood count is only one tool your health care provider uses to learn about your health. Your provider will consider your medical history, symptoms, and other factors to make a diagnosis. You may also need additional tests.
Complete Blood Count (CBC): MedlinePlus Medical Test [accessed on Jan 20, 2024]
Blood Tests - Blood Tests | NHLBI, NIH. Mar 24, 2022 [accessed on Jan 20, 2024]
Additional Materials (25)
Reticulocyte Count, Hemorrhage/Chronic Blood Loss
Reticulocytes are immature red blood cells (RBCs) released into the bloodstream from the bone marrow in which they developed. Normally, only a tiny percentage red blood cells circulating in the bloodstream are reticulocytes. The reticulocyte count rises, however, when bone marrow is called upon to produce more RBCs, in conditions such as heavy bleeding or certain types of anemia.
Image by TheVisualMD
Blood sample
During the blood collection process, medical personnel gather additional blood samples to test for an array of blood disorders and communicable diseases. Every unit of blood is rigorously tested before approved for transfusion into a patient.
Image by United States Marine Corps
Phlebotomy
Venipuncture (blood draw / collection) in the left arm of a male.
Image by MatthewLammers
Blood and Related Conditions
Blood and Related Conditions : Anemia results when there are too few red blood cells circulating in the bloodstream to deliver adequate oxygen to body tissues. There are different types and causes of anemia, including malnutrition, chronic bleeding, and diseases that result in red blood cells either being destroyed too quickly or produced too slowly.
Image by TheVisualMD
Components of Blood
Components of Blood : Our blood is composed of many different components, the largest categories being red and white blood cells (blood-clotting platelets are another key component) and the liquid portion known as blood plasma. A Complete Blood Count (CBC) includes several of the most basic, yet important, measurements of these components.
Image by TheVisualMD
Blood fractionation
Vial of separated blood. The middle layer is a type of sterile goo which separates the blood from the rest of what's drawn.
Image by Wheeler Cowperthwaite from Reno, USA
Whole Blood
A Red Cross whole blood donation before any separation
Image by Whoisjohngalt
White Blood Cells Rotation
This rotational interactive features five white blood cells. At the top left is a neutrophil (purple nucleus); center is a Monocyte-macrophage (orange nucleus); top right is a Lymphocyte (red nucleus); bottom left a Basophil (green nucleus); and bottom right an Eosinophil (yellow nucleus). These molecules are all part of a white blood cell count test. A white blood cell count is an important measure of this key component of the immune system; when the body is under attack, more WBCs are produced. White blood cells (also called leukocytes or WBCs) are in the front lines in the fight against harmful viruses, bacteria and even fungus. A white blood cell count is an important measure of this key component of the immune system; when the body is under attack, more WBCs are produced. Other factors, however, may also affect WBC counts, including allergies, chemotherapy, and other drugs, as well as leukemia.
Image by TheVisualMD
Medical Checkups
Image by TheVisualMD
Medical Checkups
Most doctors believe that people should have regular checkups as a part of preventive treatment. Regular health exams can help find problems before they begin, or in their early stages, when the chances of successful treatment are best.
Blood Pressure Reading: Photo Copyright 2005, James Gathany
Image by TheVisualMD
This browser does not support the video element.
Complete Blood Count, and Baselining Your Health
Video Topics : Our lifeblood consists of many components and a complete blood count (CBC) includes measurements of the fundamental elements. The largest categories are red and white blood cells (RBCs and WBCs) and cell fragments called platelets, which play roles in blood clotting. There are 20-30 trillion red blood cells in the body of an adult, each with a lifespan of about 100 days (RBCs contain an iron-containing protein called hemoglobin that enables them to carry oxygen to tissues throughout the body and then return carbon dioxide to the lungs). WBCs are in the front lines in the body's ongoing fight against harmful viruses, bacteria and even fungus; when a pathogen enters the body, WBCs mobilize in a coordinated defense response to eliminate, neutralize or mark the invader for destruction. The liquid portion of blood is called plasma and it carries nutrients, electrolytes, waste products, and hormones.
Video by TheVisualMD
Full Blood Count – what it tells your doctor about your health
Video by Pathology Tests Explained/YouTube
Complete Blood Count (CBC)
Video by Medicosis Perfectionalis/YouTube
Complete Blood Count
Video by Tom Wade MD/YouTube
high white blood cell count Video
Video by itbestshop/YouTube
Complete Blood Count pt1
Video by Med Immersion/YouTube
Complete Blood Count pt2
Video by Med Immersion/YouTube
This browser does not support the video element.
Normal Red Blood Cell (RBC) Count
An animation simulating a view of a healthy count of red blood cells as viewed in a slide projector or under a microscope. Initially, the screen in white with a circular black vignette along its borders. Then a still showing red blood cells slides up from the bottom left filling the screen and then comes into focus. The red blood cells resemble those taken from an scanning electron micrograph (SEM) and fill up the given space on the screen.
Video by TheVisualMD
This browser does not support the video element.
Anemic Blood Flow
Camera is stationary as it focuses on a capillary in a cell bed demonstrating anemic blood flow and it's lower red blood cell count.
Video by TheVisualMD
This browser does not support the video element.
Anemic Red Blood Cell (RBC) Count
An animation simulating a view of an unhealthy count of red blood cells as viewed in a slide projector or under a microscope. Initially, the screen in white with a circular black vignette along its borders. Then a still showing red blood cells on a light red background slides up from the bottom left filling the screen and then comes into focus. The red blood cells resemble those taken from an scanning electron micrograph (SEM). There are only a few red blood cells in this slide indicative of the low amount typical of some one who is anemic.
Video by TheVisualMD
This browser does not support the video element.
Anemic Red Blood Cell (RBC) Count
An animation simulating a close-up of an unhealthy count of red blood cells as viewed in a slide projector or under a microscope. Initially, the screen in white with a circular black vignette along its borders. Then a still showing red blood cells on a light red background slides up from the bottom left filling the screen and then comes into focus. Throughout the animation, the slide jitters a little. The red blood cells resemble those taken from an scanning electron micrograph (SEM). In this close up there are a few red blood cells along with a few white blood cells.
Video by TheVisualMD
Why Blood Tests Can Save Your Life
Video by Seeker+/YouTube
Introduction to lab values and normal ranges | Health & Medicine | Khan Academy
Video by khanacademymedicine/YouTube
Low blood counts and the risk of infection in cancer patients | Norton Cancer Institute
Video by Norton Healthcare/YouTube
Dr. Erba Describes Proper Diagnostic Testing of CML
Video by OncLiveTV/YouTube
Reticulocyte Count, Hemorrhage/Chronic Blood Loss
TheVisualMD
Blood sample
United States Marine Corps
Phlebotomy
MatthewLammers
Blood and Related Conditions
TheVisualMD
Components of Blood
TheVisualMD
Blood fractionation
Wheeler Cowperthwaite from Reno, USA
Whole Blood
Whoisjohngalt
White Blood Cells Rotation
TheVisualMD
Medical Checkups
TheVisualMD
Medical Checkups
TheVisualMD
2:12
Complete Blood Count, and Baselining Your Health
TheVisualMD
4:18
Full Blood Count – what it tells your doctor about your health
Pathology Tests Explained/YouTube
7:04
Complete Blood Count (CBC)
Medicosis Perfectionalis/YouTube
4:11
Complete Blood Count
Tom Wade MD/YouTube
8:22
high white blood cell count Video
itbestshop/YouTube
16:12
Complete Blood Count pt1
Med Immersion/YouTube
22:14
Complete Blood Count pt2
Med Immersion/YouTube
0:06
Normal Red Blood Cell (RBC) Count
TheVisualMD
0:07
Anemic Blood Flow
TheVisualMD
0:14
Anemic Red Blood Cell (RBC) Count
TheVisualMD
0:14
Anemic Red Blood Cell (RBC) Count
TheVisualMD
8:29
Why Blood Tests Can Save Your Life
Seeker+/YouTube
10:42
Introduction to lab values and normal ranges | Health & Medicine | Khan Academy
khanacademymedicine/YouTube
1:32
Low blood counts and the risk of infection in cancer patients | Norton Cancer Institute
Norton Healthcare/YouTube
2:39
Dr. Erba Describes Proper Diagnostic Testing of CML
OncLiveTV/YouTube
Red Blood Cells
Red Blood Cell (RBC) Count
Also called: Erythrocyte Count, RBC Count, Red Blood Count, Red Blood Cell Count, Red Count
A red blood cell (RBC) count is a blood test that measures the number of red blood cells in your blood. Red blood cells carry oxygen from your lungs to the rest of your body. An abnormal RBC count can be a sign of a serious health problem.
Red Blood Cell (RBC) Count
Also called: Erythrocyte Count, RBC Count, Red Blood Count, Red Blood Cell Count, Red Count
A red blood cell (RBC) count is a blood test that measures the number of red blood cells in your blood. Red blood cells carry oxygen from your lungs to the rest of your body. An abnormal RBC count can be a sign of a serious health problem.
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Use the slider below to see how your results affect your
health.
(10<sup>6</sup>)/μL
3.9
5.5
Your result is Normal.
Red blood cells (RBC) are made in the bone marrow and contain hemoglobin, a protein that carries oxygen to the tissues in the body. RBCs make up approximately 44% of the total blood volume.
Related conditions
A red blood cell (RBC) count measures the number of red blood cells, also known as erythrocytes, in your blood. Red blood cells carry oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. An RBC count that is higher or lower than normal is often the first sign of an illness. So the test may allow you to get treatment even before you have symptoms.
Other names: erythrocyte count, red count
A red blood cell (RBC) count is almost always part of a complete blood count, a group of tests that measure many different parts and features of your blood. The RBC measurement is used to help diagnose red blood cell disorders, such as anemia, a condition in which your body does not make enough healthy red blood cells.
You may get this test as part of a complete blood count, which is often included in a routine checkup. You may also need this test if you have symptoms of a low or high red blood cell count.
Symptoms of a low red blood cell count include:
Weakness
Fatigue
Pale skin
Rapid heartbeat
Symptoms of a high red blood cell count include:
Headache
Dizziness
Vision problems
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a red blood cell (RBC) count.
There is very little risk to having a blood test. There may be slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your results will show whether you have a normal red blood cell count or a count that is too low or too high.
A low red blood cell count can be a sign of:
Anemia
Leukemia, a type of blood cancer
Malnutrition, a condition in which your body does not get the calories, vitamins, and/or minerals needed for good health
Multiple myeloma, a cancer of the bone marrow
Kidney failure
It may also be a sign of pregnancy.
A high red blood cell count can be a sign of:
Dehydration
Heart disease
Polycythemia vera, a bone marrow disease that causes too many red blood cells to be made
Scarring of the lungs, often due to cigarette smoking
Lung disease
Kidney cancer
If you have questions about your results, talk to your health care provider.
If results showed you had a low or a high red blood cell count, you may need more tests to help make a diagnosis. These include:
Reticulocyte count, a test that counts the number of reticulocytes in the blood. Reticulocytes are red blood cells that are still developing. These are also known as immature red blood cells.
Iron tests, which measure iron levels in the blood. Iron is essential for making red blood cells.
Vitamin B test, which measures the amount of one or more B vitamins in the blood. B vitamins are important for making red blood cells.
Red Blood Cell (RBC) Count: MedlinePlus Medical Test [accessed on Jan 20, 2024]
RBC count: MedlinePlus Medical Encyclopedia [accessed on Jan 20, 2024]
Red Blood Cell Count (RBC) Test - Testing.com. Sep 27, 2022 [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (19)
Red blood cells
Red blood cells
Image by John Kalekos of Massachusetts image distribution for Science and Learning
Red Blood Cell
This image shows two red blood cells. The red blood cell is also called an erythrocyte: erythro is Greek for \"red,\" cyte is Latin for \"cell.\" The disc-shaped RBCs have the critical job of transporting oxygen from the lungs to the body's cells and bringing carbon dioxide from the cells back to the lungs to be expelled.
Image by TheVisualMD
Red Blood Cell in Capillary
The cardiovascular system is vast network of arteries, veins and vessels that would extend 60,000 miles if stretched end-to-end. All but a tiny fraction of this vessel network is invisible to the naked eye. The smallest capillaries (from latin "hairlike") are so narrow that red blood cells must pass through in single file. Higher than normal blood iron levels have been linked to heart disease and the reason is believed to be the oxidative stress the excess iron places on the walls of the blood vessels. It is the biological counterpart of rust. There are 20-30 trillion red blood cells (RBCs) in an adult's body. The life span of RBCs, which are produced in bone marrow, is about 100 days, which means that 2 million die (and are replaced) each second, but in that short lifetime they can make 75,000 round trips between lungs, heart and tissues in the body.
Image by TheVisualMD
Blood Smear Showing Reduced Red Blood Cell Count
Individual blood cells were first detected and described in the 17th century. Later, red blood cells (RBCs) were counted manually from a blood smear, a thin film of blood prepared on a glass slide and examined under a microscope (blood analysis is now automated, though smears are still used to detect visible abnormalities and to check or confirm the results of other tests). Anemia results when there are too few RBCs in circulation because they are being destroyed too quickly or produced too slowly. Anemia can be temporary or long term and range from mild to severe. Folate (also known as vitamin B9) is necessary for red blood cell production and the prevention of anemia, as well as the metabolism of carbohydrates. But folate also plays key roles in the synthesis and maintenance of DNA and is especially important in cell division and growth in fetal development (deficiencies of the vitamin in pregnancy is a common cause of birth defects). Pernicious anemia is a disorder in which the body's loses its ability to utilize folate and vitamin B12.
Image by TheVisualMD
Red Blood Cell (RBC)
There are 20-30 trillion red blood cells (RBCs) in an adult's body. The life span of RBCs, which are produced in bone marrow, is about 100 days, which means that 2 million die (and are replaced) each second. In their short lifetimes, however, red blood cells can make 75,000 round trips between lungs, heart and tissues in the body.
Image by TheVisualMD
Red Blood Cell
The RBC is disc-shaped and concave on both sides. The concave shape increases the cells' surface area, which allows them to distribute more oxygen to the body's cells. The shape also enables the cells to bunch together more compactly, helping them travel through the bloodstream more efficiently. Some RBCs are a bit thicker or thinner, wider or longer than others, but can change their shape to suit the demands of their environment. The cell membranes of the RBCs are protein meshes that give them flexibility, allowing them to navigate the twists and turns of the blood vessel network. The nearly 300 million hemoglobin molecules contained within each RBC easily move and slide past each other within the cell, adjusting their positions to conform to the RBC's shifting shape. Diameter : 7 μm
Image by TheVisualMD
Capillary Revealing Red Blood Cell
A portion of a capillary wall has been cut away to reveal the red blood cells flowing within.
Image by TheVisualMD
Red Blood Cell and White Blood Cell
Medical visualization of red blood cells and leukocytes.
Image by TheVisualMD
Blood Smear Showing Normal Red Blood Cell Count
Individual blood cells were first detected and described in the 17th century. Later, red blood cells were counted manually from a blood smear, a thin film of blood prepared on a glass slide and examined under a microscope. Blood analysis is now automated, though blood smears are still used to detect visible abnormalities and to check or confirm the results of other tests. There are normally between 4.2-5.8 million red blood cells per microliter (about a drop), which means there are 20-30 trillion red blood cells circulating through the body of an adult.
Image by TheVisualMD
Tubule of Nephron Revealing Many Red Blood Cell
This image shows the cut distal convoluted tubule of nephron with surrounding capillaries cut to reveal many red blood cells and healthy amounts of Erythopoeitin, EPO, (yellow particles). Erythropoeitin, EPO, is produced by the endothelial cells of the capillaries and the fibroblasts in the interstitial tissue surrounding the distal tubules. Normally, the kidneys produce EPO in response to low oxygen levels in order to stimulate red blood cell production in the bone marrow. A normal amount of red blood cells allows for the delivery of an adequate supply of oxygen.
Image by TheVisualMD
Red Blood Cell in Capillary
This image shows red blood cells traveling through capillaries, the smallest blood vessels in the body.
Image by TheVisualMD
Tubule of Nephron Revealing Few Red Blood Cell
Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli, which remove waste products from the blood while preventing the loss of other components, including proteins, electrolytes and blood cells. The glomerular filtration rate is the amount of blood that is filtered by the glomeruli per minute.
Image by TheVisualMD
This browser does not support the video element.
Complete Blood Count, and Baselining Your Health
Video Topics : Our lifeblood consists of many components and a complete blood count (CBC) includes measurements of the fundamental elements. The largest categories are red and white blood cells (RBCs and WBCs) and cell fragments called platelets, which play roles in blood clotting. There are 20-30 trillion red blood cells in the body of an adult, each with a lifespan of about 100 days (RBCs contain an iron-containing protein called hemoglobin that enables them to carry oxygen to tissues throughout the body and then return carbon dioxide to the lungs). WBCs are in the front lines in the body's ongoing fight against harmful viruses, bacteria and even fungus; when a pathogen enters the body, WBCs mobilize in a coordinated defense response to eliminate, neutralize or mark the invader for destruction. The liquid portion of blood is called plasma and it carries nutrients, electrolytes, waste products, and hormones.
Video by TheVisualMD
Red Blood Cell (RBC) Indices (Anemia Labs)
Video by Nursing School Explained/YouTube
WellnessFX: Red Blood Cell Indices Part 1 with Bryan Walsh
Video by WellnessFX/YouTube
WellnessFX: Red Blood Cell Indices Part 2 with Bryan Walsh
Video by WellnessFX/YouTube
Red Blood Cells Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
Video by NURSINGcom/YouTube
This browser does not support the video element.
Flowing Red Blood Cell (RBC)
Animation of red blood cells flowoing quicly through a blood vessel. The camera is positioned in the lumen of the vessel and the rbc's are flowing towards the viewer. The rbc and and lumen are rendered with muted colors to give it a softer look.
Video by TheVisualMD
This browser does not support the video element.
Red Blood Cell Development
This video explains red blood cell development, following a pluripotent stem cell to red blood cell.
Video by TheVisualMD
Red blood cells
John Kalekos of Massachusetts image distribution for Science and Learning
Red Blood Cell
TheVisualMD
Red Blood Cell in Capillary
TheVisualMD
Blood Smear Showing Reduced Red Blood Cell Count
TheVisualMD
Red Blood Cell (RBC)
TheVisualMD
Red Blood Cell
TheVisualMD
Capillary Revealing Red Blood Cell
TheVisualMD
Red Blood Cell and White Blood Cell
TheVisualMD
Blood Smear Showing Normal Red Blood Cell Count
TheVisualMD
Tubule of Nephron Revealing Many Red Blood Cell
TheVisualMD
Red Blood Cell in Capillary
TheVisualMD
Tubule of Nephron Revealing Few Red Blood Cell
TheVisualMD
2:12
Complete Blood Count, and Baselining Your Health
TheVisualMD
7:45
Red Blood Cell (RBC) Indices (Anemia Labs)
Nursing School Explained/YouTube
33:35
WellnessFX: Red Blood Cell Indices Part 1 with Bryan Walsh
WellnessFX/YouTube
28:05
WellnessFX: Red Blood Cell Indices Part 2 with Bryan Walsh
WellnessFX/YouTube
3:01
Red Blood Cells Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
NURSINGcom/YouTube
0:12
Flowing Red Blood Cell (RBC)
TheVisualMD
0:31
Red Blood Cell Development
TheVisualMD
White Blood Cells
White Blood Count (WBC)
Also called: WBC, WBC Blood Test, White Blood Count, White Blood Cell Count, Leukocyte Count, Leukopenia Test, Leukocytosis Test
A white blood count measures the number of white cells in your blood. White blood cells are part of the immune system. A count that is too high or too low can indicate an infection, immune system disorder, or another health problem.
White Blood Count (WBC)
Also called: WBC, WBC Blood Test, White Blood Count, White Blood Cell Count, Leukocyte Count, Leukopenia Test, Leukocytosis Test
A white blood count measures the number of white cells in your blood. White blood cells are part of the immune system. A count that is too high or too low can indicate an infection, immune system disorder, or another health problem.
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Use the slider below to see how your results affect your
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4500
11000
Your result is Normal.
Normally, people produce about 100 billion white blood cells (WBCs) a day. The total white blood cell count normally ranges between 4,500 and 11,000 WBCs per microliter.
Related conditions
A white blood count measures the number of white cells in your blood. White blood cells are part of the immune system. They help your body fight off infections and other diseases.
When you get sick, your body makes more white blood cells to fight the bacteria, viruses, or other foreign substances causing your illness. This increases your white blood count.
Other diseases can cause your body to make fewer white blood cells than you need. This lowers your white blood count. Diseases that can lower your white blood count include some types of cancer and HIV/AIDS, a viral disease that attacks white blood cells. Certain medicines, including chemotherapy, may also lower the number of your white blood cells.
There are five major types of white blood cells:
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
A white blood count measures the total number of these cells in your blood. Another test, called a blood differential, measures the amount of each type of white blood cell.
Other names: WBC count, white cell count, white blood cell count
A white blood count is most often used to help diagnose disorders related to having a high white blood cell count or low white blood cell count.
Disorders related to having a high white blood count include:
Autoimmune and inflammatory diseases, conditions that cause the immune system to attack healthy tissues
Bacterial or viral infections
Cancers such as leukemia and Hodgkin disease
Allergic reactions
Disorders related to having a low white blood count include:
Diseases of the immune system, such as HIV/AIDS
Lymphoma, a cancer of the bone marrow
Diseases of the liver or spleen
A white blood count can show if the number of your white blood cells is too high or too low, but it can't confirm a diagnosis. So it is usually done along with other tests, such as a complete blood count, blood differential, blood smear, and/or bone marrow test.
You may need this test if you have signs of an infection, inflammation, or autoimmune disease. Symptoms of infection include:
Fever
Chills
Body aches
Headache
Symptoms of inflammation and autoimmune diseases will be different, depending on the area of inflammation and type of disease.
You may also need this test if you have a disease that weakens your immune system or are taking medicine that lowers your immune response. If the test shows your white blood count is getting too low, your provider may be able to adjust your treatment.
Your newborn or older child may also be tested as part of a routine screening, or if they have symptoms of a white blood cell disorder.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out.
To test children, a health care provider will take a sample from the heel (newborns and young babies) or the fingertip (older babies and children). The provider will clean the heel or fingertip with alcohol and poke the site with a small needle. The provider will collect a few drops of blood and put a bandage on the site.
You don't need any special preparations for a white blood count.
After a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is very little risk to your baby or child with a needle stick test. Your child may feel a little pinch when the site is poked, and a small bruise may form at the site. This should go away quickly.
A high white blood count may mean you have one of the following conditions:
A bacterial or viral infection
An inflammatory disease such as rheumatoid arthritis
An allergy
Leukemia or Hodgkin disease
Tissue damage from a burn injury or surgery
A low white blood count may mean you have one of the following conditions:
Bone marrow damage. This may be caused by infection, disease, or treatments such as chemotherapy.
Cancers that affect the bone marrow
An autoimmune disorder, such as lupus (or SLE)
HIV/AIDS
If you are already being treated for a white blood cell disorder, your results may show if your treatment is working or whether your condition has improved.
If you have questions about your results, talk to your health care provider.
White blood count results are often compared with results of other blood tests, including a blood differential. A blood differential test shows the amount of each type of white blood cell, such as neutrophils or lymphocytes. Neutrophils mostly target bacterial infections. Lymphocytes mostly target viral infections.
A higher than normal amount of neutrophils is known as neutrophilia.
A lower than normal amount is known as neutropenia.
A higher than normal amount of lymphocytes is known as lymphocytosis.
A lower normal amount is known as lymphopenia.
White Blood Count (WBC): MedlinePlus Medical Test [accessed on Jan 20, 2024]
WBC count: MedlinePlus Medical Encyclopedia [accessed on Jan 20, 2024]
White Blood Cell Count (WBC Blood Test) - Testing.com. Sep 28, 2022 [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (37)
White Blood Cell Count: Bone Marrow
Disease or damage to the bone marrow, caused by infection, cancer, radiation treatment, or chemotherapy can lower white blood cell count by impairing the marrow's ability to produce new white blood cells.
Image by TheVisualMD
White Blood Cells, Bone Marrow
Bone marrow is constantly producing blood cells, including white blood cells and red blood cells as well platelets, which are cell fragments important for blood clotting. Disease and disorders of the bone marrow can, in turn, affect the production of blood cells. Both cancer and cancer treatment (chemotherapy and radiation) can also have an impact on the bone marrow's ability to produce blood cells.
Image by TheVisualMD
This browser does not support the video element.
Complete Blood Count, and Baselining Your Health
Video Topics : Our lifeblood consists of many components and a complete blood count (CBC) includes measurements of the fundamental elements. The largest categories are red and white blood cells (RBCs and WBCs) and cell fragments called platelets, which play roles in blood clotting. There are 20-30 trillion red blood cells in the body of an adult, each with a lifespan of about 100 days (RBCs contain an iron-containing protein called hemoglobin that enables them to carry oxygen to tissues throughout the body and then return carbon dioxide to the lungs). WBCs are in the front lines in the body's ongoing fight against harmful viruses, bacteria and even fungus; when a pathogen enters the body, WBCs mobilize in a coordinated defense response to eliminate, neutralize or mark the invader for destruction. The liquid portion of blood is called plasma and it carries nutrients, electrolytes, waste products, and hormones.
Video by TheVisualMD
The Immune System Explained I – Bacteria Infection
Video by Kurzgesagt – In a Nutshell/YouTube
Immune Response to Bacteria
Video by NIAID/YouTube
Immunology - Adaptive Immune System
Video by Armando Hasudungan/YouTube
Immune System - Natural Killer Cell
Video by Kyle Thornthwaite/YouTube
Your Immune System: Natural Born Killer - Crash Course Biology #32
Video by CrashCourse/YouTube
White Blood Cell and Red Blood Cell
Medical visualization of blood cells. Depicted are numerous red blood cells and a single white blood cell.
Image by TheVisualMD
White Blood Cell and Red Blood Cell
Medical visualization of blood cells. Depicted are numerous red blood cells and a single white blood cell.
Image by TheVisualMD
Red Blood Cell and White Blood Cell
Visualization of red blood cells and a white blood cell
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Blood cells (from left to right: erythrocyte, thrombocyte, leukocyte)
A single drop of blood contains millions of red blood cells, white blood cells, and platelets. One of each type is shown here, isolated from a scanning electron micrograph.
Image by Electron Microscopy Facility at The National Cancer Institute at Frederick (NCI-Frederick)
Bone structure
Anatomy of the bone. The bone is made up of compact bone, spongy bone, and bone marrow. Compact bone makes up the outer layer of the bone. Spongy bone is found mostly at the ends of bones and contains red marrow. Bone marrow is found in the center of most bones and has many blood vessels. There are two types of bone marrow: red and yellow. Red marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Yellow marrow is made mostly of fat.
Image by Smart Servier website
Blood Cells
Formed Elements of Blood
Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\"
Phagocytosis - C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response.
C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response. White blood cells are also mobilized by the immune system and CRP is believed to enhance the activity of the white blood cells called macrophages. Each type of white blood cell has its own specialized immune functions; macrophages, for example, basically engulf and \"eat\" foreign invaders such as bacteria, viruses and fungi. Macrophages in the spleen and the liver weed out old and defective red blood cells and break them into recyclables (iron, heme, and some globin) and wastes (such as bilirubin). The bilirubin is then used by the liver to produce bile, which is stored in the gallbladder and released into the small intestine to aid digestion.
Image by TheVisualMD
White blood cells
Immune cells surrounding hair follicles in mouse skin. These hair follicles are home to a diverse array of commensal bacteria.
Image by NIAID
Neutrophil
Neutrophil function, relationship to disease, and location in the human body. Credit: NIAID
Image by NIAID
Innate immune system
Image by US Gov
Macrophage Capturing Foreign Antigen
Cell-mediated immunity is an immune response that does not involve antibodies or complement but rather involves the activation of macrophages, natural killer cells (NK), antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. Macrophages are white blood cells that engulf and digest cellular debris and pathogens
Image by TheVisualMD
Mast Cell
Mast cells produce histamine. Histamine is known for its role in inflammation. It affects a variety of behavior patterns including the sleep-wake cycle and food intake. Antihistamines may work at odds with inflammation and depression.
Image by TheVisualMD
Leukocytes
Image by OpenStax College
Innate immune system
Illustration of the Innate Immune System responding to injury.
Image by OpenStax College
Eosinophilia
Drawing of an eosinophil white blood cell
Image by Iceclanl
Two neutrophils among many red blood cells. Neutrophils are one type of cell affected by chronic granulomatous disease.
Image by Uploaded by Mgiganteus
Eosinophils
Eosinophil function, relationship to disease, and location in the human body.
Image by NIAID
Sensitive content
This media may include sensitive content
Blood Cells
This is a scanning electron microscope image from normal circulating human blood. One can see red blood cells, several white blood cells including lymphocytes, amonocyte, a neutrophil, and many small disc-shaped platelets. Red cells are nonnucleated and contain hemoglobin, an important protein that contains iron and allows the cell to carry oxygen to other parts of the body. They also carry carbon dioxide away from peripheral tissue to the lungs where it can be exhaled. The infection-fighting white blood cells are classified in two main groups: granular and agranular. All blood cells are formed in the bone marrow. There are two types of agranulocytes: lymphocytes, which fight disease by producing antibodies and thus destroying foreign material, and monocytes. Platelets are tiny cells formed in bone marrow and are necessary for blood clotting.
Image by Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
Immune System and Autoimmune Diseases
Normally, an individual's immune system learns to identify and ignore all of the distinctive little structures found on that individual's own cells. Sometimes, however, it will make a mistake and identify its own body as foreign. If that happens, the immune system produces antibodies that attempt to destroy the body's own cells in the same way it would try to destroy a foreign invader.
Image by TheVisualMD
Eosinophils
Drawing of an eosinophil white blood cell
Image by BruceBlaus
Eosinophils
On the left there is a segmented polymorphonuclear neutrophil, on the right and below is one eosinophil leucocyte. For comparison the red blood cell have a diameter of 7-8 micrometers. The picture was taken with a Nikon Eclipse 600 microscope, magnification was 1000x.
Image by Davidcsaba Dr. David Csaba L.
Neutrophil action - Inflammation
Neutrophil granulocyte migrates from the blood vessel to the matrix, secreting proteolytic enzymes, in order to dissolve intercellular connections (for improvement of its mobility) and envelop bacteria through Phagocytosis.
Image by Uwe Thormann/Wikimedia
Neutrophil
Image by BruceBlaus
White Blood Cells
A type of immune cell. Most white blood cells are made in the bone marrow and are found in the blood and lymph tissue. White blood cells help the body fight infections and other diseases. Granulocytes, monocytes, and lymphocytes are white blood cells.
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
high white blood cell count Video
Video by itbestshop/YouTube
What Are White Blood Cells | Health | Biology | FuseSchool
Video by FuseSchool - Global Education/YouTube
Learning to Decode Your Blood Test Results for Chronic Lymphocytic Leukemia (CLL)
Video by CLL Society/YouTube
WellnessFX: White Blood Cells And Differential with Bryan Walsh
Video by WellnessFX/YouTube
White Blood Count
White Blood Count
Image by TheVisualMD
White Blood Cell Count: Bone Marrow
TheVisualMD
White Blood Cells, Bone Marrow
TheVisualMD
2:12
Complete Blood Count, and Baselining Your Health
TheVisualMD
6:49
The Immune System Explained I – Bacteria Infection
Kurzgesagt – In a Nutshell/YouTube
1:47
Immune Response to Bacteria
NIAID/YouTube
14:59
Immunology - Adaptive Immune System
Armando Hasudungan/YouTube
3:02
Immune System - Natural Killer Cell
Kyle Thornthwaite/YouTube
15:02
Your Immune System: Natural Born Killer - Crash Course Biology #32
CrashCourse/YouTube
White Blood Cell and Red Blood Cell
TheVisualMD
White Blood Cell and Red Blood Cell
TheVisualMD
Red Blood Cell and White Blood Cell
TheVisualMD
Sensitive content
This media may include sensitive content
Blood cells (from left to right: erythrocyte, thrombocyte, leukocyte)
Electron Microscopy Facility at The National Cancer Institute at Frederick (NCI-Frederick)
Bone structure
Smart Servier website
Blood Cells
Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\"
Phagocytosis - C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response.
TheVisualMD
White blood cells
NIAID
Neutrophil
NIAID
Innate immune system
US Gov
Macrophage Capturing Foreign Antigen
TheVisualMD
Mast Cell
TheVisualMD
Leukocytes
OpenStax College
Innate immune system
OpenStax College
Eosinophilia
Iceclanl
Two neutrophils among many red blood cells. Neutrophils are one type of cell affected by chronic granulomatous disease.
Uploaded by Mgiganteus
Eosinophils
NIAID
Sensitive content
This media may include sensitive content
Blood Cells
Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
Immune System and Autoimmune Diseases
TheVisualMD
Eosinophils
BruceBlaus
Eosinophils
Davidcsaba Dr. David Csaba L.
Neutrophil action - Inflammation
Uwe Thormann/Wikimedia
Neutrophil
BruceBlaus
White Blood Cells
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
8:22
high white blood cell count Video
itbestshop/YouTube
3:12
What Are White Blood Cells | Health | Biology | FuseSchool
FuseSchool - Global Education/YouTube
1:17:17
Learning to Decode Your Blood Test Results for Chronic Lymphocytic Leukemia (CLL)
CLL Society/YouTube
16:52
WellnessFX: White Blood Cells And Differential with Bryan Walsh
A platelet count test measures the number of platelets in your blood. Platelets, also known as thrombocytes, are small blood cells that are essential for blood clotting. Platelets may be counted to monitor or diagnose diseases, or to look for the cause of too much bleeding or clotting.
A platelet count test measures the number of platelets in your blood. Platelets, also known as thrombocytes, are small blood cells that are essential for blood clotting. Platelets may be counted to monitor or diagnose diseases, or to look for the cause of too much bleeding or clotting.
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Use the slider below to see how your results affect your
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10³/μL
50
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Your result is Normal.
A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood. Platelets are tiny blood cells that are made in the bone marrow from larger cells. When you are injured, platelets stick together to form a plug to seal your wound. This plug is called a blood clot.
Related conditions
Platelets, also known as thrombocytes, are small blood cells that are essential for blood clotting. Clotting is the process that helps you stop bleeding after an injury. There are two types of platelet tests: a platelet count test and platelet function tests.
A platelet count test measures the number of platelets in your blood. A lower than normal platelet count is called thrombocytopenia. This condition can cause you to bleed too much after a cut or other injury that causes bleeding. A higher than normal platelet count is called thrombocytosis. This can make your blood clot more than you need it to. Blood clots can be dangerous because they can block blood flow.
Other names: platelet count, thrombocyte count
A platelet count is most often used to monitor or diagnose conditions that cause too much bleeding or too much clotting. A platelet count may be included in a complete blood count, a test that is often done as part of a regular checkup.
You may need platelet count testing if you have symptoms of having too few or too many platelets.
Symptoms of too few platelets include:
Prolonged bleeding after a minor cut or injury
Nosebleeds
Unexplained bruising
Pinpoint sized red spots on the skin, known as petechiae
Purplish spots on the skin, known as purpura. These may be caused by bleeding under the skin.
Heavy and/or prolonged menstrual periods
Symptoms of too many platelets include:
Numbness of hands and feet
Headache
Dizziness
Weakness
Most platelet tests are done on a blood sample.
During the test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a platelet count test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If your results show a lower than normal platelet count (thrombocytopenia), it may indicate:
A cancer that affects the blood, such as leukemia or lymphoma
A viral infection, such as mononucleosis, hepatitis, or measles
An autoimmune disease. This is a disorder that causes the body to attack its own healthy tissues, which can include platelets.
Infection or damage to the bone marrow
Cirrhosis
Vitamin B12 deficiency
Gestational thrombocytopenia, a common, but mild, low-platelet condition affecting pregnant women. It is not known to cause any harm to a mother or her unborn baby. It usually gets better on its own during pregnancy or after birth.
If your results show a higher than normal platelet count (thrombocytosis), it may indicate:
Certain types of cancer, such as lung cancer or breast cancer
Anemia
Inflammatory bowel disease
Rheumatoid arthritis
A viral or bacterial infection
Platelet Tests: MedlinePlus Medical Test [accessed on Jan 20, 2024]
Platelet Count (PLT) Blood Test - Testing.com. Dec 19, 2023 [accessed on Jan 20, 2024]
Platelet count: MedlinePlus Medical Encyclopedia [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
Platelet Development
Illustration of Platelet Development
Image by OpenStax College
Sensitive content
This media may include sensitive content
Platelet Disorders
From left to right: erythrocyte, thrombocyte, leukocyte
Image by Electron Microscopy Facility at The National Cancer Institute at Frederick (NCI-Frederick)
Scheme of a blood sample after centrifugation
scheme of a blood sample after centrifugation
Image by KnuteKnudsen (talk)
Decode Your Blood Test: Platelets 💉 | Merck Manual Consumer Version
Video by Merck Manuals/YouTube
This browser does not support the video element.
Complete Blood Count, and Baselining Your Health
Video Topics : Our lifeblood consists of many components and a complete blood count (CBC) includes measurements of the fundamental elements. The largest categories are red and white blood cells (RBCs and WBCs) and cell fragments called platelets, which play roles in blood clotting. There are 20-30 trillion red blood cells in the body of an adult, each with a lifespan of about 100 days (RBCs contain an iron-containing protein called hemoglobin that enables them to carry oxygen to tissues throughout the body and then return carbon dioxide to the lungs). WBCs are in the front lines in the body's ongoing fight against harmful viruses, bacteria and even fungus; when a pathogen enters the body, WBCs mobilize in a coordinated defense response to eliminate, neutralize or mark the invader for destruction. The liquid portion of blood is called plasma and it carries nutrients, electrolytes, waste products, and hormones.
Video by TheVisualMD
Platelets Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
Video by NURSINGcom/YouTube
Platelets Explained in Two Minutes
Video by American Red Cross/YouTube
The life and times of RBCs and platelets
Video by khanacademymedicine/YouTube
Platelet Development
OpenStax College
Sensitive content
This media may include sensitive content
Platelet Disorders
Electron Microscopy Facility at The National Cancer Institute at Frederick (NCI-Frederick)
Scheme of a blood sample after centrifugation
KnuteKnudsen (talk)
0:48
Decode Your Blood Test: Platelets 💉 | Merck Manual Consumer Version
Merck Manuals/YouTube
2:12
Complete Blood Count, and Baselining Your Health
TheVisualMD
3:54
Platelets Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
NURSINGcom/YouTube
1:47
Platelets Explained in Two Minutes
American Red Cross/YouTube
10:35
The life and times of RBCs and platelets
khanacademymedicine/YouTube
Hemoglobin
Hemoglobin Blood Test
Also called: Hemoglobin, Hgb
A hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen. Abnormal levels may mean you have anemia or another blood disorder.
Hemoglobin Blood Test
Also called: Hemoglobin, Hgb
A hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen. Abnormal levels may mean you have anemia or another blood disorder.
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Use the slider below to see how your results affect your
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g/dL
13.8
17.2
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Heme, an iron-containing molecule, combines with globin proteins to form hemoglobin, which carries oxygen in red blood cells from the lungs to the rest of the body.
Related conditions
A hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. If your hemoglobin levels are abnormal, it may be a sign that you have a blood disorder.
Other names: Hb, Hgb
A hemoglobin test is often used to check for anemia, a condition in which your body has fewer red blood cells than normal. If you have anemia, the cells in your body don't get all the oxygen they need. Hemoglobin tests are measured as part of a complete blood count (CBC).
Your health care provider may order the test as part of a routine exam, or if you have:
Symptoms of anemia, which include weakness, dizziness, and cold hands and feet
A family history of thalassemia, sickle cell anemia, or other inherited blood disorder
A diet low in iron and other minerals
A long-term infection
Excessive blood loss from an injury or surgical procedure
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparation for a hemoglobin test. If your health care provider has ordered other tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. After the test, some people experience mild pain, dizziness, or bruising. These symptoms usually go away quickly.
There are many reasons your hemoglobin levels may not be in the normal range.
Low hemoglobin levels may be a sign of:
Different types of anemia
Thalassemia
Iron deficiency
Liver disease
Cancer and other diseases
High hemoglobin levels may be a sign of:
Lung disease
Heart disease
Polycythemia vera, a disorder in which your body makes too many red blood cells. It can cause headaches, fatigue, and shortness of breath.
If any of your levels are abnormal, it doesn't always mean you have a medical condition that needs treatment. Diet, activity level, medicines, a menstrual period, and other factors can affect the results. You may also have higher than normal hemoglobin levels if you live in a high altitude area. Talk with your provider to learn what your results mean.
Some forms of anemia are mild, while other types of anemia can be serious and even life threatening if not treated. If you are diagnosed with anemia, be sure to talk to your health care provider to find out the best treatment plan for you.
Hemoglobin Test: MedlinePlus Medical Test [accessed on Jan 20, 2024]
Hemoglobin: MedlinePlus Medical Encyclopedia [accessed on Jan 20, 2024]
Hemoglobin - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (16)
Hemoglobin | Human anatomy and physiology | Health & Medicine | Khan Academy
Video by Khan Academy/YouTube
Blood, Part 2 - There Will Be Blood: Crash Course A&P #30
Video by CrashCourse/YouTube
Haemoglobin
Video by Wellcome Trust/YouTube
Hemoglobin A1c & Diabetes
Video by DiabeTV/YouTube
Hemoglobin Molecule
Molecule of hemoglobin.
Image by TheVisualMD
Hemoglobin A1C Molecule
Hemoglobin is a protein found inside red blood cells that carries oxygen from the lungs to cells throughout the body. Hemoglobin also binds with glucose. Diabetics have too much glucose in the bloodstream and this extra glucose binds (or glycates) with hemoglobin. Glycated hemoglobin usually stays glycated for the life of the red blood cell (about 3 months). Therefore, the percentage of hemoglobin that is glycated (measured as A1C) reflects glucose levels that have affected red blood cells up to 3 months in the past. The hemoglobin A1C test measures the percentage of hemoglobin bound to blood sugar (glucose); the test is used to diagnose type 1 and type 2 diabetes. Because the test results reflect average blood sugar levels over a period of 2-3 months (rather than daily fluctuations), the hemoglobin A1C test is also used to gauge how well patients are managing their diabetes over time.
Image by TheVisualMD
Hemoglobin A1C: Red Blood Cells
Red blood cells use the iron-rich protein hemoglobin to carry oxygen from the lungs to cells throughout the body and return carbon dioxide to the lungs. The percentage of hemoglobin bound to blood glucose (hemoglobin A1C) is used to diagnose diabetes.
Image by TheVisualMD
Hemoglobin of Red Blood Cell
Hemoglobin is an iron-containing protein found in red blood cells that binds oxygen and carbon dioxide for transport and delivery to different parts of the body.
Image by TheVisualMD
Hemoglobin Molecule
Hemoglobin is an iron-rich protein that is packed inside RBCs. It is a structurally complex molecule that can change shape to either hold or release oxygen, depending on the body's need. There are close to 300 million hemoglobin molecules within each RBC.
Image by TheVisualMD
Hemoglobin Molecule Heme Group
A heme group in a hemoglobin molecule consists of an iron atom bound equally to four nitrogen atoms, all lying in one plane. The iron atom is the site of oxygen binding.
Image by TheVisualMD
This browser does not support the video element.
Hemoglobin Within Red Blood Cell (RBC)
A red blood cell rushes toward the camera, the camera enters the cell to focus on all of the hemoglobin molecules within
Video by TheVisualMD
Hemoglobin, Carbon Monoxide
Hemoglobin is an iron-containing protein that enables red blood cells to deliver oxygen from the lungs to cells throughout the body. But the same binding site on the hemoglobin molecule has an even stronger affinity for carbon monoxide, which is why we are so susceptible to poisoning by this deadly gas; carbon monoxide grabs all the binding sites and starves the body's tissues of oxygen
Image by TheVisualMD
This browser does not support the video element.
Hemoglobin A1c
The hemoglobin A1c test measures the percentage of hemoglobin bound to blood sugar (glucose); the test is used to diagnose type 1 and type 2 diabetes. Because the test results reflect average blood sugar levels over a period of 2-3 months (rather than daily fluctuations), the hemoglobin A1C test is also used to gauge how well patients are managing their diabetes over time.
Video by TheVisualMD
Hemoglobin A1c
The hemoglobin A1c test measures the percentage of hemoglobin bound to blood sugar (glucose); the test is used to diagnose type 1 and type 2 diabetes. Because the test results reflect average blood sugar levels over a period of 2-3 months (rather than daily fluctuations), the hemoglobin A1C test is also used to gauge how well patients are managing their diabetes over time.
Image by TheVisualMD
Hemoglobin: O2 Binding Hemoglobin
Hemoglobin normally binds to life-sustaining oxygen. But the same binding site on the hemoglobin molecule has an even stronger affinity for carbon monoxide, which is why we are so susceptible to poisoning by this deadly gas.
Image by TheVisualMD
HemoglobinA1C
Hemoglobin Test for O2 Binding Hemoglobin : A hemoglobin test is a measurement of your blood's oxygen-carrying capacity. High levels of hemoglobin can be the result of dehydration, lung disease and other conditions. Low levels of hemoglobin indicate that there is a shortage of red blood cells; this can be the result of RBCs being lost or destroyed too quickly or produced too slowly. Hemoglobin is an iron-containing protein that enables red blood cells to deliver oxygen from the lungs to cells throughout the body. But the same binding site on the hemoglobin molecule has an even stronger affinity for carbon monoxide, which is why we are so susceptible to poisoning by this deadly gas; carbon monoxide grabs all the binding sites and starves the body's tissues of oxygen.
Image by TheVisualMD
14:34
Hemoglobin | Human anatomy and physiology | Health & Medicine | Khan Academy
Khan Academy/YouTube
10:01
Blood, Part 2 - There Will Be Blood: Crash Course A&P #30
CrashCourse/YouTube
5:31
Haemoglobin
Wellcome Trust/YouTube
1:43
Hemoglobin A1c & Diabetes
DiabeTV/YouTube
Hemoglobin Molecule
TheVisualMD
Hemoglobin A1C Molecule
TheVisualMD
Hemoglobin A1C: Red Blood Cells
TheVisualMD
Hemoglobin of Red Blood Cell
TheVisualMD
Hemoglobin Molecule
TheVisualMD
Hemoglobin Molecule Heme Group
TheVisualMD
0:27
Hemoglobin Within Red Blood Cell (RBC)
TheVisualMD
Hemoglobin, Carbon Monoxide
TheVisualMD
0:27
Hemoglobin A1c
TheVisualMD
Hemoglobin A1c
TheVisualMD
Hemoglobin: O2 Binding Hemoglobin
TheVisualMD
HemoglobinA1C
TheVisualMD
Hematocrit
Hematocrit Blood Test
Also called: Hematrocit, HCT, Crit, Packed Cell Volume, PCV
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells. Hematocrit levels that are too high or too low can be a sign of a blood disorder, dehydration, or other medical conditions that affect your blood.
Hematocrit Blood Test
Also called: Hematrocit, HCT, Crit, Packed Cell Volume, PCV
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells. Hematocrit levels that are too high or too low can be a sign of a blood disorder, dehydration, or other medical conditions that affect your blood.
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Use the slider below to see how your results affect your
health.
{score}
40.7
50.3
Your result is Normal.
Normal hematocrit levels vary based on age and race. In adults, normal levels for men range from 41%-50%. For women, the normal range is slightly lower: 36%-44%.
Related conditions
A hematocrit test is a blood test that measures how much of your blood is made up of red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body. The other parts of your blood include white blood cells (to help fight infection), platelets (to help make blood clots to stop bleeding), and a liquid called plasma.
Hematocrit levels that are too high or too low can be a sign of a blood disorder, dehydration, or other medical conditions that affect your blood.
Other names: HCT, packed cell volume, PCV, Crit; H and H (Hemoglobin and Hematocrit)
A hematocrit test is often part of a complete blood count (CBC). A CBC is a common blood test that measures the different parts of your blood. It is used to check your general health. It may also be used to help diagnose blood disorders, including anemia, a condition in which you don't have enough red blood cells, and polycythemia, an uncommon disorder in which you have too many red blood cells and your blood becomes too thick.
Your health care provider may order a hematocrit test as part of your regular checkup or to monitor your health if you are being treated for cancer or have an ongoing health condition. Your provider may also order this test if you have symptoms of a red blood cell disorder, such as anemia or polycythemia:
Symptoms of anemia (too few red blood cells) may include:
Shortness of breath
Weakness or fatigue
Headache
Dizziness
Arrhythmia (a problem with the rate or rhythm of your heartbeat)
Symptoms of polycythemia (too many red blood cells) may include:
Headache
Feeling light-headed or dizzy
Shortness of breath
Weakness or fatigue
Skin symptoms such as itching after a shower or bath, burning, or a red face
Heavy sweating, especially during sleep
Blurred or double vision and blind spots
Bleeding gums and heavy bleeding from small cuts
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a hematocrit test. If your provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a hematocrit test or other type of blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your hematocrit test results are reported as a number. That number is the percentage of your blood that's made of red blood cells. For example, if your hematocrit test result is 42, it means that 42% of your blood is red blood cells and the rest is white blood cells, platelets, and blood plasma.
A hematocrit level that's lower than normal may be a sign that:
Your body doesn't have enough red blood cells (anemia). There are many types of anemia that can be caused by different medical conditions.
Your body is making too many white blood cells, which may be caused by:
Bone marrow disease
Certain cancers, including leukemia, lymphoma, multiple myeloma, or cancers that spread to the bone marrow from other parts of the body
A hematocrit level that's higher than normal may be a sign that:
Your body is making too many red blood cells, which may be caused by:
Lung disease
Congenital heart disease
Heart failure
Polycythemia
Your blood plasma level is too low, which may be caused by:
Dehydration, the most common cause of a high hematocrit
Shock
If your results are not in the normal range, it doesn't always mean that you have a medical condition that needs treatment. Living at high altitudes where there's less oxygen in the air may cause a high hematocrit. That's because your body responds to low oxygen levels by making more red blood cells so that you get the oxygen you need.
Pregnancy can cause a low hematocrit. That's because the body has more fluid than normal during pregnancy, which decreases the percentage that's made of red blood cells.
To learn what your test results mean, talk with your provider.
Normal hematocrit levels will be different depending on your sex, age, and the altitude where you live. Ask your provider what hematocrit level is normal for you.
Hematocrit Test: MedlinePlus Medical Test [accessed on Jan 20, 2024]
Hematocrit: MedlinePlus Medical Encyclopedia [accessed on Jan 20, 2024]
Hematrocit Blood Test - Testing.com. Sep 13, 2022 [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (30)
This browser does not support the video element.
Complete Blood Count, and Baselining Your Health
Video Topics : Our lifeblood consists of many components and a complete blood count (CBC) includes measurements of the fundamental elements. The largest categories are red and white blood cells (RBCs and WBCs) and cell fragments called platelets, which play roles in blood clotting. There are 20-30 trillion red blood cells in the body of an adult, each with a lifespan of about 100 days (RBCs contain an iron-containing protein called hemoglobin that enables them to carry oxygen to tissues throughout the body and then return carbon dioxide to the lungs). WBCs are in the front lines in the body's ongoing fight against harmful viruses, bacteria and even fungus; when a pathogen enters the body, WBCs mobilize in a coordinated defense response to eliminate, neutralize or mark the invader for destruction. The liquid portion of blood is called plasma and it carries nutrients, electrolytes, waste products, and hormones.
Video by TheVisualMD
Vial of Centrifuged Blood
Blood is made up of red and white blood cell (as well as platelets), suspended in a liquid known as blood plasma. Plasma, which makes up 55% of our blood's volume, is a clear liquid (mainly water) that transports food molecules, hormones, waste as well as a wide range of dissolved chemicals. Red cells, which normally make up 40-50% of total blood volume, are produced continuously in our bone marrow at the rate of about 2-3 million cells per second. White cells make up a very small part of blood's volume-normally only about 1% in healthy people. This image shows two vials of centrifuged blood. The left vial shows healthy amount of red blood cells in female (36-44%) ; The right vial shows healthy amount of red blood cells in male (41-50%). The hematocrit (along with the hemoglobin test) is the central test to diagnosing anemia in that it indicates the amount of RBCs in the blood.
Image by TheVisualMD
Red Blood Cells, Bone Marrow
A skeleton may have a dry and lifeless Halloween image, but bone is actually dynamic, living tissue. Bone is not uniformly solid; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). As the source of blood cells, the bone marrow is critical to health. Disease or damage to bone marrow can result in either too many or too few blood cells.
Hematocrit Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing
Video by NURSINGcom/YouTube
Hematocrit, Dehydration
Blood is composed of cells (primarily red blood cells, but also white blood cells and cell fragments called platelets) along with a liquid portion known as plasma. The ratio of the volume of red blood cells to the volume of plasma is an important health indicator and is known as the hematocrit. The most common cause of a high hematocrit is dehydration, which is usually temporary and easily remedied by increasing fluid intake, thereby restores the balance between RBCs and blood plasma volume.
Image by TheVisualMD
Hematocrit, Anemia
Blood is composed of cells (primarily red blood cells, but also white blood cells and cell fragments called platelets) along with a liquid portion known as plasma. The ratio of the volume of red blood cells to the volume of plasma is an important health indicator and is known as the hematocrit. A low hematocrit usually indicates anemia, which occurs when red blood cells are being either destroyed too quickly or produced too slowly; with fewer red blood cells, less oxygen is delivered to body tissues.
Image by TheVisualMD
Vial of Blood for Hematocrit Test
This image is a vial of blood that has been centrifuged (and thus separated) to determine hematocrit. This vial shows, from top to bottom, 55% plasma, <1% white blood cells, <1% platelets , 45% red blood cells. Hematocrit measures how much of the blood, by volume, is taken up by RBCs. A normal range for hematocrit is 41 to 50 percent in men and 36 to 44 percent in women. In many cases, a reading below the normal range for hematocrit will lead to a diagnosis of CKD-related anemia.This other diagnostic test is the hemoglobin test, which measures the amount of hemoglobin molecules in the blood and is a good indicator of the body's ability to carry oxygen throughout the body.
Image by TheVisualMD
Hematocrit: Bone Marrow
Bone marrow produces about 2 million red blood cells (RBCs) a second to maintain a healthy hematocrit. Many conditions, including kidney disease, chemotherapy, and dietary deficiencies, can reduce RBC production, while others can result in too many RBCs.
Image by TheVisualMD
Hematocrit: Blood Cells
The hematocrit is another way to look at the health of red blood cells (RBCs). Blood is composed of cells (primarily RBCs) and a liquid portion called plasma. The proportions of RBCs and plasma must be kept in balance and this is what the hematocrit measures.
Image by TheVisualMD
Blood
Components of Blood : Blood is mostly made up of plasma and red and white blood cells. But it also contains many other substances as well, like platelets, hormones, nutrients such as glucose, and fats like cholesterol. Blood is the fluid of life, transporting oxygen from the lungs to body tissue and carbon dioxide from body tissue to the lungs.
Image by TheVisualMD
Hematocrit
Hematocrit Blood Vials : If you are at risk for cardiovascular disease, your doctor may order a cholesterol and triglyceride level test as well as a complete blood count (CBC). Abnormal results may be the first clue in determining risk of and in diagnosing cardiovascular disease.
Image by TheVisualMD
Blood Smear Showing Reduced Red Blood Cell Count
Individual blood cells were first detected and described in the 17th century. Later, red blood cells (RBCs) were counted manually from a blood smear, a thin film of blood prepared on a glass slide and examined under a microscope (blood analysis is now automated, though smears are still used to detect visible abnormalities and to check or confirm the results of other tests). Anemia results when there are too few RBCs in circulation because they are being destroyed too quickly or produced too slowly. Anemia can be temporary or long term and range from mild to severe. Folate (also known as vitamin B9) is necessary for red blood cell production and the prevention of anemia, as well as the metabolism of carbohydrates. But folate also plays key roles in the synthesis and maintenance of DNA and is especially important in cell division and growth in fetal development (deficiencies of the vitamin in pregnancy is a common cause of birth defects). Pernicious anemia is a disorder in which the body's loses its ability to utilize folate and vitamin B12.
Image by TheVisualMD
Blood Smear Showing Normal Red Blood Cell Count
Individual blood cells were first detected and described in the 17th century. Later, red blood cells were counted manually from a blood smear, a thin film of blood prepared on a glass slide and examined under a microscope. Blood analysis is now automated, though blood smears are still used to detect visible abnormalities and to check or confirm the results of other tests. There are normally between 4.2-5.8 million red blood cells per microliter (about a drop), which means there are 20-30 trillion red blood cells circulating through the body of an adult.
Image by TheVisualMD
This browser does not support the video element.
Red Blood Cells Carry Oxygen
This video focuses on one of the main components of blood, the red blood cell and its function to carry oxygen. The video begins with revealing the red blood cells and the heart that pumps the oxygenated blood to the rest of the body. Hemoglobin is the protein molecule found in these red blood cells that enable blood to transport oxygen. If the blood's capacity to transport oxygen to the tissues is reduced due to a decrease in the number of red blood cells, anemia may occur.
Video by TheVisualMD
Components of Blood
Components of Blood : Our blood is composed of many different components, the largest categories being red and white blood cells (blood-clotting platelets are another key component) and the liquid portion known as blood plasma. A Complete Blood Count (CBC) includes several of the most basic, yet important, measurements of these components.
Image by TheVisualMD
Blood and Related Conditions
Blood and Related Conditions : Anemia results when there are too few red blood cells circulating in the bloodstream to deliver adequate oxygen to body tissues. There are different types and causes of anemia, including malnutrition, chronic bleeding, and diseases that result in red blood cells either being destroyed too quickly or produced too slowly.
Image by TheVisualMD
Pellet of Lymphocyte Cells Created in the Centrifuge
This photograph shows Wendy Watford, Ph.D. holding a test tube containing isolated lymphocyte cells. The cells were spun in a centrifuge to create a pellet at the bottom of the test tube. The cells will be labeled with CFSE dye, which will stain the membranes of the cells. After culturing the cells for three days she will determine the number of cell divisions that have taken place by measuring the dilution of the CFSE dye. The purpose of the work is to measure the proliferation of lymphocytes under various conditions. The principal investigator for this work is John J. O’Shea, M.D., NIAMS Scientific Director.
Image by NIAMS/Photographer: Rhoda Baer
Red Blood Cells
Digital holographic microscopy (DHM) image of red blood cells.
Image by Egelberg (talk)
Test Tube
Between 5,000 and 8,000 blood serum, fecal, urine, viral and respiratory samples arrive six days a week from U.S. Air Force hospitals and clinics worldwide, as well as some other Department of Defense facilities, for analysis at the Epidemiology Laboratory Service, also known as the "Epi Lab" at the 711th Human Performance Wing’s United States Air Force School of Aerospace Medicine and Public Health at Wright Patterson AFB, Ohio.The lab is a Department of Defense reference laboratory offering clinical diagnostic, public health, and force health screening and testing. (U.S. Air Force photo by J.M. Eddins Jr.)
Image by U.S. Air Force photo by J.M. Eddins Jr.
Phlebotomy
This image was uploaded as part of Wiki Loves e-textbooks contest in Poland.
Image by Sean Michael Ragan
Red Blood Cells Carry Oxygen
This video focuses on one of the main components of blood, the red blood cell and its function to carry oxygen. The video begins with revealing the red blood cells and the heart that pumps the oxygenated blood to the rest of the body. Hemoglobin is the protein molecule found in these red blood cells that enable blood to transport oxygen. If the blood's capacity to transport oxygen to the tissues is reduced due to a decrease in the number of red blood cells, anemia may occur.
Image by TheVisualMD
Composition of Blood
Composition of Blood
Image by OpenStax College
Hematology | Hematocrit
Video by Ninja Nerd/YouTube
Erythrocyte indices (Hemoglobin, Hematocrit, MCV, MCH & MCHC) What Do These Lab Tests Mean?
Video by Medicosis Perfectionalis/YouTube
How to Interpret RBC Indices (e.g. hemoglobin vs. hematocrit, MCV, RDW)
Video by Strong Medicine/YouTube
Haematocrit or PCV
Video by LabsforLifeProject/YouTube
Packed cell volume/ Hematocrit
Video by Pathology Simplified/YouTube
Fetal hemoglobin and hematocrit | Human anatomy and physiology | Health & Medicine | Khan Academy
Also called: MCV, MCV Blood Test, Mean Corpuscular Volume, Mean RBC Volume
A mean corpuscular volume (MCV) blood test measures the size of your red blood cells. If blood cells are too small or too large, it may indicate a blood disorder.
MCV (Mean Corpuscular Volume) Test
Also called: MCV, MCV Blood Test, Mean Corpuscular Volume, Mean RBC Volume
A mean corpuscular volume (MCV) blood test measures the size of your red blood cells. If blood cells are too small or too large, it may indicate a blood disorder.
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Use the slider below to see how your results affect your
health.
fL
76
96
Your result is Normal.
A normal MCV indicates that the red blood cells are normal average size, or normocytic. Normal results vary based on the laboratory and the method used.
Related conditions
MCV stands for mean corpuscular volume. An MCV blood test measures the average size of your red blood cells.
Red blood cells carry oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a lack of certain vitamins, or other medical conditions.
Other names: CBC with differential
An MCV blood test is often part of a complete blood count (CBC). A CBC is a common blood test that measures many parts of your blood, including red blood cells. It is used to check your general health.
An MCV test may also be used with other tests to help diagnose or monitor certain blood disorders, including anemia. There are many types of anemia. An MCV test can help diagnose which type of anemia you have.
Your health care provider may order a complete blood count, which includes an MCV test, as part of your regular checkup. You may also have the test if you have a chronic (long-lasting) condition that could lead to anemia or if you have the symptoms of anemia:
Shortness of breath
Weakness or fatigue
Headache
Dizziness
Arrhythmia (a problem with the rate or rhythm of your heartbeat)
During the test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for an MCV blood test. If your provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
An MCV test alone cannot diagnose any disease. Your provider will use the results of your MCV, other test results, and your medical history to make a diagnosis.
If your results show that your red blood cells are smaller than normal, it may be a sign of:
Certain types of anemia, including iron-deficiency anemia, the most common type
Thalassemia, an uncommon genetic condition
If your results show that your red blood cells are larger than normal, it may be a sign of:
Pernicious anemia, which may be caused by:
A lack of vitamin B12
A disease that affects your body's ability to use vitamin B12, such as certain autoimmune diseases, celiac disease, or Crohn's disease.
Anemia caused by a lack of folic acid
Liver disease
It's also possible to have anemia with a normal MCV. This may happen if anemia is caused by conditions, such as:
A sudden loss of blood
Kidney failure
Aplastic anemia (uncommon)
If your MCV levels are not in the normal range, it doesn't always mean that you have a medical problem that needs treatment. Diet, activity level, medicines, a menstrual period, and other conditions can affect the test results. Talk with your health care provider to learn what your results mean.
If your provider thinks you may have anemia or another blood disorder, you may have other red blood cell tests with an MCV. These tests may include a red blood cell count and measurements of hemoglobin. All together, these tests are called red blood cell indices.
MCV (Mean Corpuscular Volume): MedlinePlus Medical Test [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (22)
Microcytic, normocytic, and macrocytic anemias | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Non-megaloblastic Macrocytic Anemia
Video by Medicosis Perfectionalis/YouTube
Microcytic anemia | Hematologic System Diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Living with and Managing Iron-Deficiency Anemia
Video by NHLBI/YouTube
Hemolytic Anemia
Video by DrER.tv/YouTube
Medical School - Anemia Made Easy
Video by iMedicalSchool/YouTube
Iron deficency anemia diagnosis | Hematologic System Diseases | NCLEX-RN | Khan Academy
WellnessFX: Red Blood Cell Indices Part 1 with Bryan Walsh
Video by WellnessFX/YouTube
WellnessFX: Red Blood Cell Indices Part 2 with Bryan Walsh
Video by WellnessFX/YouTube
Blood Brain Barrier Endothelium
The blood-brain barrier keeps potentially toxic substances from entering the brain. The semipermeable membrane formed by the tightly spaced cells of capillaries in this area selectively screens out large molecules, while permitting the transport of essential nutrients such as glucose. The endothelium is the cellular lining of the blood vessel and is made up of endothelial cells connected to one another by tight junctions. These are the strongest cell-to-cell adhesions in the body. Toxic materials being transported in the blood are too large to pass through these junctions and exit the blood. Therefore, the brain is protected from exposure to many harmful substances. The barrier is does not, however, prevent fat-soluble materials from entering the brain; this includes alcohol and nicotine.
Image by TheVisualMD
Normal Blood Glucose Levels in Capillary
This image depicts a healthy capillary with normal glucose (pink) and insulin (yellow) levels. Capillaries, the smallest blood vessels in your body, are where nutrients are transferred from blood to cells, and waste from cells to blood. The body's cells depend on sugar in the blood, which is derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood-sugar (glucose) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher than normal levels characterize hyperglycemia.
Image by TheVisualMD
Cross-Section of Healthy Capillary Blood Vessel with Normal Glucose and Insulin Levels
This image depicts a healthy capillary. Capillaries are the smallest blood vessels in your body and are where the transfer of nutrients from blood to cells and wastes from cells to the blood takes place.The cells of the body depend on sugar in the blood, derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood-sugar (glucose) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher than normal levels hyperglycemia.
Image by TheVisualMD
Blood Vessels in the Brain
The Blood Brain Barrier and Astrocytes type 1
Image by Ben Brahim Mohammed
Cross-Section of Damaged Capillary Blood Vessel with Very High Glucose and Insulin Levels
This image depicts an unhealthy, damaged capillary with very high levels of insulin and glucose. Capillaries, the smallest blood vessels in your body, are where nutrients are transferred from blood to cells, and waste from cells to the blood The body's cells depend on sugar (glucose) in the blood, which is derived from carbohydrates, for food and energy. Without insulin, glucose is not able to enter cells to be used as fuel. Allowing for the innumerable differences among individuals, the threshold for a normal blood-sugar (glucose) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Higher than normal levels lead to hyperglycemia. Hyperglycemia is the hallmark of prediabetes (between 100 and 125 mg/dL) and diabetes (126 mg/dL and higher). It is caused by either too little insulin being released by the pancreas or the body's inability to use insulin properly. Hyperglycemia leads to microangiopathy, marked by endothelial cell apoptosis (programmed cell death), accumulation of AGEs (advanced glycation end products), and thickening of the basement membrane, which can lead to development of lesions, vasoconstriction, and altered vessel function
Blood Components
This image highlights the vital components of blood: 55% plasma Plasma is the liquid river that transports every blood cell to its destination. Oxygen-carrying RBCs couldn't move through arteries, veins and capillaries without it. Even though it is a watery, almost clear fluid, plasma contains many important substances, including blood-clotting agents called platelets and protective proteins called antibodies which help us fight infection. When the clotting agents are removed from blood plasma, it is called serum, which is essential in many life-saving medical situations such as transplant surgery and trauma. <1% white blood cells (wbcs or leukocytes) Some leukocytes are produced in the bone marrow, while others are generated in lymph nodes scattered throughout the body. They are far less numerous than their sister RBCs, but leukocytes are the bedrock of the immune system and are the body's front line of defense. Different types of leukocytes fight infections in different ways. Some target bacterial or fungal infections, while others respond to parasitic threats or allergic reactions. <1% platelets Platelets perform the vital function of clotting blood at wound sites. They are small, even in comparison to the other cells of your blood, but they pack a wallop when it comes to healing a scrape or staunching a more serious wound. When you cut yourself shaving, platelets arrive on the scene like your personal emergency medical team, creating a natural bandage of clotted blood, which eventually forms a scab. 45% red blood cells rbcs or erythrocytes) RBCs are produced in the bone marrow and perform the fundamental task of delivering oxygen to all of the body's cells. The vial is an example of the hematocrit, one of many tests that make up the complete blood count (CBC). Hematocrit measures the volume of RBCs in your blood. A normal hematocrit reading for women is between 36 to 44 percent; for men it's 41 to 50 percent.
Image by TheVisualMD
Test Tube Containing Blood
Visualization of a test tube containing blood. Blood comprises of 55% plasma, 1% platelets and white blood cells, and 45% red blood cells.
Image by TheVisualMD
Blood Smear Showing Reduced Red Blood Cell Count
Individual blood cells were first detected and described in the 17th century. Later, red blood cells (RBCs) were counted manually from a blood smear, a thin film of blood prepared on a glass slide and examined under a microscope (blood analysis is now automated, though smears are still used to detect visible abnormalities and to check or confirm the results of other tests). Anemia results when there are too few RBCs in circulation because they are being destroyed too quickly or produced too slowly. Anemia can be temporary or long term and range from mild to severe. Folate (also known as vitamin B9) is necessary for red blood cell production and the prevention of anemia, as well as the metabolism of carbohydrates. But folate also plays key roles in the synthesis and maintenance of DNA and is especially important in cell division and growth in fetal development (deficiencies of the vitamin in pregnancy is a common cause of birth defects). Pernicious anemia is a disorder in which the body's loses its ability to utilize folate and vitamin B12.
Image by TheVisualMD
Red Blood Cell in Capillary
The cardiovascular system is vast network of arteries, veins and vessels that would extend 60,000 miles if stretched end-to-end. All but a tiny fraction of this vessel network is invisible to the naked eye. The smallest capillaries (from latin "hairlike") are so narrow that red blood cells must pass through in single file. Higher than normal blood iron levels have been linked to heart disease and the reason is believed to be the oxidative stress the excess iron places on the walls of the blood vessels. It is the biological counterpart of rust. There are 20-30 trillion red blood cells (RBCs) in an adult's body. The life span of RBCs, which are produced in bone marrow, is about 100 days, which means that 2 million die (and are replaced) each second, but in that short lifetime they can make 75,000 round trips between lungs, heart and tissues in the body.
Image by TheVisualMD
Kidney and Stem Cell Creating Red Blood Cell. B12 is critical for the creation of red blood cells.
We are used to thinking of our kidneys mostly as hardworking filters that rid our bodies of wastes and excess water. But the kidneys are also constantly monitoring and adjusting levels of key substances in the blood, depending on what the body needs. Specialized cells in the kidney that are very sensitive to low oxygen levels, for example, produce a hormone called erythropoietin (EPO), which in turn promotes the production of red blood cells in the bone marrow. The boost in red blood cells increases the oxygen-carrying capacity of the blood.
Image by TheVisualMD
Healthy Capillary Blood Vessel
Cross-section of Healthy Capillary Blood Vessel with Normal Glucose and Insulin Levels
Cross-Section of Damaged Capillary Blood Vessel with Very High Glucose and Insulin Levels
1
2
3
Healthy Capillary Blood Vessel and and Damaged Capillary Blood Vessel Caused by High Levels of Blood Glucose
1) Healthy Capillary Blood Vessel - This image depicts a healthy capillary. Capillaries are the smallest blood vessels in your body. They can be so thin in diameter that blood cells have to bend in order to pass through. Capillaries are where the transfer of nutrients from the blood to cells, and the transfer of waste from cells to blood, takes place. In a healthy body, the blood vessels are smooth and elastic.
2) Cross-Section of Healthy Capillary Blood Vessel with Normal Glucose and Insulin Levels - This image depicts a healthy capillary. The body's cells depend on sugar in the blood, which is derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood sugar (glucose, pink) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher-than-normal levels characterize hyperglycemia. Without insulin (yellow), glucose is not able to enter cells to be used as fuel. Because of this, healthy insulin levels are a key factor in keeping blood glucose levels normal.
3) Cross-Section of Damaged Capillary Blood Vessel with Very High Glucose and Insulin Levels - This image depicts an unhealthy, damaged capillary with very high levels of insulin and glucose. Higher than normal levels of blood glucose lead to hyperglycemia. Hyperglycemia is the hallmark of prediabetes (between 100 and 125 mg/dL) and diabetes (126 mg/dL and higher). It is caused by either too little insulin being released by the pancreas or the body's inability to use insulin properly. Hyperglycemia leads to microangiopathy, marked by endothelial cell apoptosis (programmed cell death), accumulation of AGEs (advanced glycation end products), and thickening of the basement membrane, which can lead to the development of lesions, vasoconstriction, and altered vessel function
Interactive by TheVisualMD
5:57
Microcytic, normocytic, and macrocytic anemias | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
4:39
Non-megaloblastic Macrocytic Anemia
Medicosis Perfectionalis/YouTube
9:42
Microcytic anemia | Hematologic System Diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
3:56
Living with and Managing Iron-Deficiency Anemia
NHLBI/YouTube
3:24
Hemolytic Anemia
DrER.tv/YouTube
3:16
Medical School - Anemia Made Easy
iMedicalSchool/YouTube
9:54
Iron deficency anemia diagnosis | Hematologic System Diseases | NCLEX-RN | Khan Academy
WellnessFX: Red Blood Cell Indices Part 1 with Bryan Walsh
WellnessFX/YouTube
28:05
WellnessFX: Red Blood Cell Indices Part 2 with Bryan Walsh
WellnessFX/YouTube
Blood Brain Barrier Endothelium
TheVisualMD
Normal Blood Glucose Levels in Capillary
TheVisualMD
Cross-Section of Healthy Capillary Blood Vessel with Normal Glucose and Insulin Levels
TheVisualMD
Blood Vessels in the Brain
Ben Brahim Mohammed
Cross-Section of Damaged Capillary Blood Vessel with Very High Glucose and Insulin Levels
Blood Components
TheVisualMD
Test Tube Containing Blood
TheVisualMD
Blood Smear Showing Reduced Red Blood Cell Count
TheVisualMD
Red Blood Cell in Capillary
TheVisualMD
Kidney and Stem Cell Creating Red Blood Cell. B12 is critical for the creation of red blood cells.
TheVisualMD
Healthy Capillary Blood Vessel and and Damaged Capillary Blood Vessel Caused by High Levels of Blood Glucose
TheVisualMD
Bone Marrow Biopsy
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative bone marrow biopsy results indicates that the bone marrow didn’t have any significant findings with all of the testing that was done. This may mean that certain diseases were not found. It may also mean that the bone marrow is functioning normally.
Related conditions
Bone marrow is a soft, spongy tissue found in the center of most bones. Bone marrow makes different types of blood cells, including:
Red blood cells (also called erythrocytes), which carry oxygen from your lungs to every cell in your body
White blood cells (also called leukocytes), which help you fight infections
Platelets, which help with blood clotting
Bone marrow tests check to see if your bone marrow is working correctly and making normal amounts of blood cells. The tests can help diagnose and monitor bone marrow disorders, blood disorders, and certain types of cancer.
There are two types of procedures used to collect bone marrow samples for testing:
Bone marrow aspiration removes a small amount of bone marrow fluid and cells
Bone marrow biopsy removes a small piece of bone and bone marrow
Bone marrow aspiration and bone marrow biopsy are usually done at the same time.
Other names: bone marrow examination
Bone marrow tests are used to:
Find out the cause of problems with red blood cells, white blood cells, or platelets
Diagnose and monitor blood disorders, such as:
Anemia (when the cause is unknown)
Polycythemia vera
Thrombocytopenia
Diagnose bone marrow disorders
Diagnose and monitor treatment for certain types of cancers, including leukemia, multiple myeloma, and lymphoma
Diagnose the cause of an unexplained fever, which could be from an infection in the bone marrow
Your health care provider may order a bone marrow aspiration and a bone marrow biopsy if other blood tests show your levels of red blood cells, white blood cells, or platelets are not normal.
Too many or too few blood cells may mean you have a medical condition, such as cancer that starts in your blood or bone marrow. If you are being treated for another type of cancer, these tests can find out if the cancer has spread to your bone marrow.
Bone marrow tests may also be used to see how well cancer treatment is working.
Bone marrow aspiration and bone marrow biopsy procedures are usually done at the same time. A health care provider will collect the marrow samples for testing. Usually, the samples can be collected in about ten minutes.
Before the procedure, you may be asked to put on a hospital gown. Your blood pressure, heart rate, and temperature will be checked.
You may choose to have a mild sedative, which is medicine to help you relax. You may also have the choice to use stronger medicine that will make you sleep. Your provider can help you decide which option is best for you.
During the procedure:
You'll lie down on your side or your stomach, depending on which bone will be used to get the samples. Most bone marrow samples are taken from the back of the hip bone, called the iliac crest. But other bones may be used.
An area of skin over the bone will be cleaned with an antiseptic.
You will get an injection (shot) of medicine to numb the skin and the bone underneath. It may sting.
When the area is numb, the provider will make a very small incision (cut) in your skin and insert a hollow needle. You will need to lie very still during the procedure:
The bone marrow aspiration is usually done first. The provider will push the needle into the bone and use a syringe attached to the needle to pull out bone marrow fluid and cells. You may feel a brief, sharp pain. The aspiration takes only a few minutes.
The bone marrow biopsy uses a special hollow biopsy needle inserted through the same skin opening. The provider will twist the needle into the bone to take out a small piece, or core, of bone marrow tissue. You may feel some pressure or brief pain while the sample is being taken.
After the test, the health care provider will cover your skin with a bandage.
If you didn't use medicine to relax or sleep, you'll usually need to stay lying down for about 15 minutes to make sure that the bleeding has stopped. Afterwards, you can do your usual activities as soon as you are able. If you used medicine to relax or sleep, you'll need to stay longer before you can go home. You may also need to rest the next day.
Your provider will tell you whether you need to fast (not eat or drink) for a few hours before the procedure.
Plan to have someone take you home after the test, because you may be drowsy if you are given medicine to help you relax or sleep during the procedure.
You'll receive instructions for how to prepare, but be sure to ask your provider any questions you have about the procedure.
After a bone marrow aspiration and bone marrow biopsy you may feel stiff or sore where the sample was taken. This usually goes away in a few days.
Your provider may recommend or prescribe a pain reliever to help. Don't take any pain medicine your provider hasn't approved. Certain pain relievers, such as aspirin, could increase your risk of bleeding.
Serious symptoms are very rare, but may include:
Increased pain or discomfort where the sample was taken
Redness, swelling, bleeding, or other fluids leaking from at the site
Fever
If you have any of these symptoms, call your provider.
It may take several days or even weeks to get your bone marrow test results. Your provider may have ordered many different types of tests on your marrow sample, so the results often include a lot of complex information. Your provider can explain what your results mean.
In certain cases, if your test results are not normal, you may need to have more tests to confirm a diagnosis or to decide which treatment would be best.
If you have cancer that affects your bones and marrow, your test results may provide information about your cancer stage, which is how much cancer you have in your body and how fast it may be growing.
If you are already being treated for cancer, your test results may show:
How well your treatment is working
Whether your treatment is affecting your bone marrow
Bone Marrow Tests: MedlinePlus Medical Test [accessed on Feb 16, 2024]
Additional Materials (22)
Bone marrow: location and labeled histology (preview) | Kenhub
Video by Kenhub - Learn Human Anatomy/YouTube
What to expect when you have a Bone Marrow Test | Cancer Research UK
Video by Cancer Research UK/YouTube
Having a bone marrow test
Video by Design Science/YouTube
Bone Marrow Transplant - Mayo Clinic
Video by Mayo Clinic/YouTube
Bone Marrow Diseases - What You Need To Know
Video by Rehealthify/YouTube
What Does Bone Marrow Actually Do?
Video by Seeker/YouTube
Aplastic Anemia-Bone Marrow
Image by doctorssupport.org
Bone Marrow Procedure Site
A 3D medical animation still showing preferred Sites for Bone Marrow Aspiration. The preferred sites for the procedure.
Image by Scientific Animations, Inc.
Image of a bone marrow harvest
Georgetown University Hospital, Washington, D.C. -- Surgeon Dr. Hans Janovich performs a bone marrow harvest operation on Aviation Electronics Technician 1st Class Michael Griffioen. The procedure consists of inserting a large-gauge syringe into an area of the hip and extracting the bone marrow. It is transfused into the recipient, and helps to recreate and replenish T-cells and the white and red blood cells killed while undergoing chemotherapy. Griffioen is assigned to the Pre-commissioning Unit Ronald Reagan (CVN 76) and was matched with an anonymous cancer patient through the Department of Defense Marrow Donor Program.
Image by Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to make red blood cells needed to carry oxygen throughout the body. Diseased kidneys don’t make enough EPO, and bone marrow then makes fewer red blood cells.
Image by NIDDK Image Library
Red Blood Cells, Bone Marrow
A skeleton may have a dry and lifeless Halloween image, but bone is actually dynamic, living tissue. Bone is not uniformly solid; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). As the source of blood cells, the bone marrow is critical to health. Disease or damage to bone marrow can result in either too many or too few blood cells.
Image by TheVisualMD
Erythropoiesis in Bone Marrow
Bone is dynamic, living tissue; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). Specialized cells in the kidney, which are sensitive to low oxygen levels, produce a hormone called erythropoietin (EPO), which in turn promotes the production of red blood cells. The boost in red blood cell production (erythropoiesis) in turn increases the oxygen-carrying capacity of the blood.
Image by TheVisualMD
Bone Marrow
Red bone marrow fills the head of the femur, and a spot of yellow bone marrow is visible in the center. The white reference bar is 1 cm.
Image by CNX Openstax
This browser does not support the video element.
Femur Bone Marrow Revealing Lacunae and Trabeculae
Camera descending into bone marrow dataset. Within the bone matrix that is shown one can see the spaces in the matrix which are called lacunae and the trabeculae which is a the mesh work of bone tissue
Video by TheVisualMD
Hematopoietic System of Bone Marrow
Hemopoiesis is the proliferation and differentiation of the formed elements of blood.
Image by CNX Openstax
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
White blood cells (WBCs) and red blood cells (RBCs), as well as the cell fragments called platelets, are constantly being produced by bone marrow. Disease, cancer and genetic disorders of bone marrow can, in turn, affect the production of blood cells.
Image by TheVisualMD
Bone marrow core biopsy microscopy panorama
Section of bone marrow core biopsy as seen under the microscope.
Image by Gabriel Caponetti
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by John Doe
Bone Marrow Biopsy
Diagram showing a bone marrow biopsy.
Image by Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
Disease or damage to the bone marrow, caused by infection, cancer, radiation treatment, or chemotherapy can lower white blood cell count by impairing the marrow's ability to produce new white blood cells.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Blood Cells
This is a scanning electron microscope image from normal circulating human blood. One can see red blood cells, several white blood cells including lymphocytes, amonocyte, a neutrophil, and many small disc-shaped platelets. Red cells are nonnucleated and contain hemoglobin, an important protein that contains iron and allows the cell to carry oxygen to other parts of the body. They also carry carbon dioxide away from peripheral tissue to the lungs where it can be exhaled. The infection-fighting white blood cells are classified in two main groups: granular and agranular. All blood cells are formed in the bone marrow. There are two types of agranulocytes: lymphocytes, which fight disease by producing antibodies and thus destroying foreign material, and monocytes. Platelets are tiny cells formed in bone marrow and are necessary for blood clotting.
Image by Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
3:24
Bone marrow: location and labeled histology (preview) | Kenhub
Kenhub - Learn Human Anatomy/YouTube
2:12
What to expect when you have a Bone Marrow Test | Cancer Research UK
Cancer Research UK/YouTube
5:56
Having a bone marrow test
Design Science/YouTube
2:20
Bone Marrow Transplant - Mayo Clinic
Mayo Clinic/YouTube
1:38
Bone Marrow Diseases - What You Need To Know
Rehealthify/YouTube
4:03
What Does Bone Marrow Actually Do?
Seeker/YouTube
Aplastic Anemia-Bone Marrow
doctorssupport.org
Bone Marrow Procedure Site
Scientific Animations, Inc.
Image of a bone marrow harvest
Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
NIDDK Image Library
Red Blood Cells, Bone Marrow
TheVisualMD
Erythropoiesis in Bone Marrow
TheVisualMD
Bone Marrow
CNX Openstax
0:06
Femur Bone Marrow Revealing Lacunae and Trabeculae
TheVisualMD
Hematopoietic System of Bone Marrow
CNX Openstax
Bone Marrow Biopsy
Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
TheVisualMD
Bone marrow core biopsy microscopy panorama
Gabriel Caponetti
Bone Marrow Biopsy
John Doe
Bone Marrow Biopsy
Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
TheVisualMD
Sensitive content
This media may include sensitive content
Blood Cells
Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
BCR-ABL Genetic Test
BCR-ABL1 Genetic Test
Also called: Philadelphia Chromosome Test
A BCR-ABL1 genetic test uses a sample of blood or bone marrow to look for an abnormal gene called BCR-ABL1. The test helps diagnose certain blood cancers, mainly chronic myeloid leukemia (CML). It also helps to monitor treatment.
BCR-ABL1 Genetic Test
Also called: Philadelphia Chromosome Test
A BCR-ABL1 genetic test uses a sample of blood or bone marrow to look for an abnormal gene called BCR-ABL1. The test helps diagnose certain blood cancers, mainly chronic myeloid leukemia (CML). It also helps to monitor treatment.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means no BCR or ABL1 gene rearrangement observed.
Related conditions
A BCR-ABL1 genetic test uses a sample of blood or bone marrow to look for an abnormal gene called BCR-ABL1. This abnormal gene is involved in certain types of blood cancer. It's found in:
Most people who have chronic myeloid leukemia (CML), which is also called chronic granulocytic leukemia or chronic myeloid leukemia
Some people who have certain types of acute lymphoblastic leukemia (ALL)
Some people with acute myeloid leukemia (AML), but very rarely
The abnormal BCR-ABL1 gene is made when two separate genes merge together and become one gene. Genes are short sections of DNA. DNA is made of long strands of material that carry information that controls what you look like and how your body works. DNA is packaged into structures in your cells called chromosomes. Normally, most of your cells have the same set of 23 pairs of chromosomes.
The abnormal BCR-ABL1 gene is formed when pieces of chromosomes 9 and 22 break off and trade places. The broken piece of chromosome 9 includes part of the ABL1 gene. It attaches (fuses) to part of the BCR gene on chromosome 22. This makes the abnormal fusion gene, BCR-ABL1. The changed chromosome 22 is called a "Philadelphia chromosome" after the city where researchers discovered it.
Your genes carry special instructions for making proteins that help your cells do their work. But the abnormal BCR-ABL1 gene has instructions for an abnormal protein. The protein causes certain bone marrow cells to make large numbers of abnormal white blood cells. These abnormal white blood cells are leukemia cells. They don't protect you from infections like healthy white blood cells do. They can build up in the blood and bone marrow and crowd out healthy blood cells.
There are different types of BCR-ABL1 genetic tests. They check your blood or bone marrow for:
The abnormal BCR-ABL1 gene
Changes in chromosome 22 that show it has become a Philadelphia chromosome
An abnormal BCR-ABL1 gene is an acquired genetic change. That means you don't inherit it from your parents, and you can't pass it on to your children. Acquired changes happen after birth if cells make a mistake when dividing to make new cells or if your DNA is damaged from exposure to substances that cause cancer. The changes show up only in certain types of cells. Changes in your genes are also called mutations or variants.
Other names: BCR-ABL, BCR-ABL fusion, Philadelphia chromosome, B-cell acute lymphoblastic leukemia (B-ALL), chronic myelogenous leukemia (CML), t(9;22), BCR-ABL1 Transcript Detection by RT-PCR, Quantitative BCR-ABL1 Translocation Detection by RT-PCR
BCR-ABL1 genetic testing is most often used with other tests to diagnose or rule out two specific types of blood cancer:
Chronic myeloid leukemia (CML).
Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). This is a type of acute lymphoblastic leukemia that has the Philadelphia chromosome.
Certain types of BCR-ABL1 testing may also be used to help plan treatment for these blood cancers. There are several treatment options. Some medicines target the protein made by the BCR-ABL1 gene. In general, these types of medicines cause less harm to normal cells than cancer chemotherapy or radiation therapy do.
During treatment, BCR-ABL1 tests may be used to see if cancer treatment working. And after treatment is finished, testing is often used to see if cancer is coming back.
If your health care provider thinks you may have a type of leukemia that involves the BCR-ABL1 gene, you may need a BCR-ABL1 genetic test to make a diagnosis. Signs and symptoms of these blood cancers include:
High levels of white blood cells on a complete blood count (CBC) test
Fatigue
Fever
Weight loss
Night sweats (heavy sweating during sleep)
Joint or bone pain
Pain or fullness below your ribs on the left side
Painless lumps in your armpits, groin, neck, or belly
If you have already been diagnosed with a type of leukemia that involves a BCR-ABL1 gene, you may need this test to:
Help guide treatment decisions
See how well your treatment is working (if treatment is helping, the number of cells with BCR-ABL1 genes will decrease.)
Monitor your health after treatment to see if blood cancer is coming back
A BCR-ABL1 genetic test usually uses a sample of blood or bone marrow.
If you are having a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
If you are having a bone marrow test, a provider usually takes a sample from the back of the hip bone. You will be given an injection (shot) of medicine to numb the area. You may also be given medicine to help you relax or sleep.
A bone marrow test has two parts that are usually done one after the other:
For a bone marrow aspiration, the provider pushes a thin needle into the bone and removes a sample of bone marrow fluid with a syringe attached to the needle.
For a bone marrow biopsy, the provider inserts a hollow needle into the bone and twists the needle to take out a small piece of bone marrow tissue. You may feel some pressure or brief pain while the sample is being taken.
The procedure takes only a few minutes. Afterwards, the area will be bandaged. You'll stay lying down for about 15 minutes to make sure the bleeding stops. You may need to stay longer if you had medicine to relax or sleep.
You usually don't need any special preparations for a blood test. If you're having a bone marrow test, your provider will tell you whether you need to fast (not eat or drink) for a few hours before the procedure.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
After a bone marrow test, you may feel stiff or sore where the sample was taken. This usually goes away in a few days. If you need pain relief, talk with your provider.
If you had BCR-ABL1 genetic testing to diagnose a blood cancer, your provider will probably use the results of more than one test to make a diagnosis. Your provider will likely diagnose either chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) if your tests show all three of these results:
Abnormal white blood cells
The BCR-ABL1 gene
The Philadelphia chromosome
In certain cases, a person may have CML without having the Philadelphia chromosome, but this isn't common.
If you had a BCR-ABL1 gene test to see if your cancer treatment is working, your provider will compare your results with past test results to look for changes over time. The way your results are reported depends on which test you had. Ask your provider to explain what your test results mean for your health and treatment plan. In general:
If the amount of BCR-ABL1 in your sample decreases, it means your treatment is working to some degree. Your test results may describe your response to treatment using words such as minor, minimal, partial, major, or complete.
If the amount of BCR-ABL1 in your sample increases, it may mean your treatment is not working. You may need to try another treatment or have more tests. An increase in BCR-ABL1 levels after successful treatment, may mean your cancer has come back.
Labs use different methods to test for the BCR-ABL1 gene and Philadelphia chromosome. The test method can affect your results. So, it's important to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. If you have questions about how your tests are done, ask your provider.
BCR-ABL1 Genetic Test: MedlinePlus Medical Test [accessed on Apr 01, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
Philadelphia Chromosome
Philadelphia Chromosome Translocation
Image by A Obeidat in ar.wikipedia
A small, hypolobated megakaryocyte (center of field) in a bone marrow aspirate, typically of chronic myelogenous leukemia
Chronic myelogenous (or myeloid) leukemia (CML), also known as chronic granulocytic leukemia (CGL) : A small, hypolobated megakaryocyte (center of field) in a bone marrow aspirate, typically of chronic myelogenous leukemia.
Image by Difu Wu
Philadelphia Chromosome
Schematic of the Philadelphia chromosome formation. Philadelphia chromosome. A piece of chromosome 9 and a piece of chromosome 22 break off and trade places. The bcr-abl gene is formed on chromosome 22 where the piece of chromosome 9 attaches. The changed chromosome 22 is called the Philadelphia chromosome.
Image by Aryn89
Leukemia cells during remission / relapse
This intricate process, which involves a particular subset of genes, sometimes fails and leads to infertility.
Image by Darryl Leja, NHGRI
3D Medical Animation still showing Leukemia
3D Medical Animation still showing an increase in white blood cells of a person suffering from Leukemia.
Image by Scientific Animations, Inc.
Leukemia
Blood Cells (Normal and Leukemia) Description: A two-panel drawing of normal blood cells and blood cells with leukemia. Platelets, red blood cells (rbc's), white blood cells (wbc's), plasma (fluid), and blast cells are labeled.
Image by National Cancer Institute, Alan Hoofring (Illustrator)
Adaptive Immune Response
After initially binding an antigen to the B cell receptor (BCR), a B cell internalizes the antigen and presents it on MHC II. A helper T cell recognizes the MHC II–antigen complex and activates the B cell. As a result, memory B cells and plasma cells are made.
Image by CNX Openstax
White Blood Cells in Leukemia
The increase in white blood cells in leukemia
Image by Scientific Animations, Inc.
Philadelphia Chromosome
A Obeidat in ar.wikipedia
A small, hypolobated megakaryocyte (center of field) in a bone marrow aspirate, typically of chronic myelogenous leukemia
Difu Wu
Philadelphia Chromosome
Aryn89
Leukemia cells during remission / relapse
Darryl Leja, NHGRI
3D Medical Animation still showing Leukemia
Scientific Animations, Inc.
Leukemia
National Cancer Institute, Alan Hoofring (Illustrator)
Adaptive Immune Response
CNX Openstax
White Blood Cells in Leukemia
Scientific Animations, Inc.
Staging
Blood cells of patients with chronic myeloid leukemia
Image by Антоненко Світлана
Blood cells of patients with chronic myeloid leukemia
Blood cells of patients with chronic myeloid leukemia.Fluorescent microscopy (100Х)
Image by Антоненко Світлана
What Are the Stages of Chronic Myelogenous Leukemia?
KEY POINTS
After chronic myelogenous leukemia has been diagnosed, tests are done to find out if the cancer has spread.
Chronic myelogenous leukemia has 3 phases.
Chronic phase
Accelerated phase
Blastic phase
Chronic myelogenous leukemia can relapse (return) after it has been treated.
After chronic myelogenous leukemia has been diagnosed, tests are done to find out if the cancer has spread.
The extent or spread of cancer is usually described as stages. In chronic myelogenous leukemia (CML), the disease is classified by phase: chronic phase, accelerated phase, or blastic phase. It is important to know the phase in order to plan treatment. The information from tests and procedures done to diagnose chronic myelogenous leukemia is also used to plan treatment.
Chronic myelogenous leukemia has 3 phases.
As the amount of blast cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may result in infections, anemia, and easy bleeding, as well as bone pain and pain or a feeling of fullness below the ribs on the left side. The number of blast cells in the blood and bone marrow and the severity of signs or symptoms determine the phase of the disease.
Chronic phase
In chronic phase CML, fewer than 10% of the cells in the blood and bone marrow are blast cells.
Accelerated phase
In accelerated phase CML, 10% to 19% of the cells in the blood and bone marrow are blast cells.
Blastic phase
In blastic phase CML, 20% or more of the cells in the blood or bone marrow are blast cells. When tiredness, fever, and an enlarged spleen occur during the blastic phase, it is called blast crisis.
Chronic myelogenous leukemia can relapse (return) after it has been treated.
In relapsed CML, the number of blast cells increases after a remission.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (5)
Phasing or staging CML
Video by Blood Cancer UK/YouTube
Chronic Myeloid Leukemia (CML): What are CML milestones?
Video by Leukemia & Lymphoma Society/YouTube
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
A small, hypolobated megakaryocyte (center of field) in a bone marrow aspirate, typically of chronic myelogenous leukemia
Chronic myelogenous (or myeloid) leukemia (CML), also known as chronic granulocytic leukemia (CGL) : A small, hypolobated megakaryocyte (center of field) in a bone marrow aspirate, typically of chronic myelogenous leukemia.
Image by Difu Wu
1:14
Phasing or staging CML
Blood Cancer UK/YouTube
2:46
Chronic Myeloid Leukemia (CML): What are CML milestones?
Leukemia & Lymphoma Society/YouTube
9:50
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
A small, hypolobated megakaryocyte (center of field) in a bone marrow aspirate, typically of chronic myelogenous leukemia
Difu Wu
Treatment
Chemotherapy vials (2)
Image by Bill Branson (Photographer)/Wikimedia
Chemotherapy vials (2)
Title Chemotherapy Vials
Description Variety of chemotherapy drugs in bottles.
Topics/Categories Treatment, Chemotherapy
Type B&W, Photo
Source National Cancer Institute
Image by Bill Branson (Photographer)/Wikimedia
How Is Chronic Myelogenous Leukemia Treated?
Treatment Option Overview
KEY POINTS
There are different types of treatment for patients with chronic myelogenous leukemia.
Six types of standard treatment are used:
Targeted therapy
Chemotherapy
Immunotherapy
High-dose chemotherapy with stem cell transplant
Donor lymphocyte infusion (DLI)
Surgery
New types of treatment are being tested in clinical trials.
Treatment for chronic myelogenous leukemia may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with chronic myelogenous leukemia.
Different types of treatment are available for patients with chronic myelogenous leukemia (CML). Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Six types of standard treatment are used:
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells.
Tyrosine kinase inhibitor therapy: This treatment blocks the enzyme, tyrosine kinase, that causes stem cells to develop into more white blood cells (blasts) than the body needs. Imatinib mesylate, dasatinib, nilotinib, ponatinib, bosutinib, and asciminib are tyrosine kinase inhibitors used to treat CML.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
Immunotherapy
Immunotherapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer.
Interferon: Interferon affects the division of cancer cells and can slow tumor growth.
High-dose chemotherapy with stem cell transplant
High doses of chemotherapy are given to kill cancer cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. Stem cell transplant is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
Stem cell transplant. (Step 1): Blood is taken from a vein in the arm of the donor. The patient or another person may be the donor. The blood flows through a machine that removes the stem cells. Then the blood is returned to the donor through a vein in the other arm. (Step 2): The patient receives chemotherapy to kill blood-forming cells. The patient may receive radiation therapy (not shown). (Step 3): The patient receives stem cells through a catheter placed into a blood vessel in the chest.
Donor lymphocyte infusion (DLI)
Donor lymphocyte infusion (DLI) is a cancer treatment that may be used after stem cell transplant. Lymphocytes (a type of white blood cell) from the stem cell transplant donor are removed from the donor’s blood and may be frozen for storage. The donor’s lymphocytes are thawed if they were frozen and then given to the patient through one or more infusions. The lymphocytes see the patient’s cancer cells as not belonging to the body and attack them.
Surgery
Splenectomy is surgery to remove the spleen.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Treatment of Chronic Phase Chronic Myelogenous Leukemia
Treatment of chronic phase chronic myelogenous leukemia may include the following:
Targeted therapy with a tyrosine kinase inhibitor (imatinib mesylate, nilotinib, dasatinib, bosutinib).
High-dose chemotherapy with donor stem cell transplant.
Chemotherapy.
Splenectomy.
A clinical trial of lower-dose chemotherapy with donor stem cell transplant.
A clinical trial of a new treatment.
Treatment of Accelerated Phase Chronic Myelogenous Leukemia
Treatment of accelerated phase chronic myelogenous leukemia may include the following:
Donor stem cell transplant.
Targeted therapy with a tyrosine kinase inhibitor (imatinib mesylate).
Tyrosine kinase inhibitor therapy followed by a donor stem cell transplant.
Immunotherapy (interferon) with or without chemotherapy.
High-dose chemotherapy.
Chemotherapy.
A clinical trial of a new treatment.
Treatment of Blastic Phase Chronic Myelogenous Leukemia
Treatment of blastic phase chronic myelogenous leukemia may include the following:
Targeted therapy with a tyrosine kinase inhibitor (imatinib mesylate, dasatinib, nilotinib, bosutinib).
High-dose chemotherapy.
Donor stem cell transplant.
Chemotherapy as palliative therapy to relieve symptoms and improve quality of life.
A clinical trial of a new treatment.
Treatment of Relapsed Chronic Myelogenous Leukemia
In relapsed CML, the number of blast cells increases after a remission. Treatment of relapsed chronic myelogenous leukemia may include the following:
Targeted therapy with a tyrosine kinase inhibitor (dasatinib, nilotinib, bosutinib, asciminib, or higher doses of imatinib mesylate).
Donor stem cell transplant.
Chemotherapy.
Donor lymphocyte infusion.
Immunotherapy (interferon).
A clinical trial of new types or higher doses of targeted therapy or donor stem cell transplant.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (6)
Treatment of CML | Tyrosine Kinase (TK) Inhibitors
Video by Medicosis Perfectionalis/YouTube
What is chronic myelogenous leukemia? | Hematologic System Diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Acute Myeloid Leukemia Ep. 1: Needle in a Haystack | MedscapeTV
This intricate process, which involves a particular subset of genes, sometimes fails and leads to infertility.
Image by Darryl Leja, NHGRI
Breast Cancer: treatment for triple negative breast cancer
U.S. Air Force Capt. Candice Adams reacts to the effects of a chemotherapy treatment Jan. 25, 2011 at Walter Reed Army Medical Center. Adams was diagnosed with triple negative breast cancer at age 29. (U.S. Air Force photo by Staff Sgt. Russ Scalf)
Drugs Approved for Chronic Myelogenous Leukemia (CML)
Development and Elimination of Cancer Cells as Chemotherapy is Applied
Image by IdkItsKatieB
Development and Elimination of Cancer Cells as Chemotherapy is Applied
Development and Elimination of Cancer Cells as Chemotherapy is Applied
Image by IdkItsKatieB
Drugs Approved for Chronic Myelogenous Leukemia (CML)
This page lists cancer drugs approved by the Food and Drug Administration (FDA) for leukemia. The list includes generic and brand names. This page also lists common drug combinations used in leukemia. The individual drugs in the combinations are FDA-approved. However, drug combinations themselves usually are not approved, but are widely used.
Drugs Approved for Chronic Myelogenous Leukemia (CML)
Asciminib Hydrochloride
Bosulif (Bosutinib)
Bosutinib
Busulfan
Busulfex (Busulfan)
Cyclophosphamide
Cytarabine
Dasatinib
Dexamethasone
Gleevec (Imatinib Mesylate)
Hydrea (Hydroxyurea)
Hydroxyurea
Iclusig (Ponatinib Hydrochloride)
Imatinib Mesylate
Myleran (Busulfan)
Nilotinib
Omacetaxine Mepesuccinate
Ponatinib Hydrochloride
Scemblix (Asciminib Hydrochloride)
Sprycel (Dasatinib)
Synribo (Omacetaxine Mepesuccinate)
Tasigna (Nilotinib)
Source: National Cancer Institute (NCI)
Prognosis
Genomic information
Image by NHS HEE Genomics Education Programme
Genomic information
This image was created by the NHS HEE Genomics Education Programme. For further information and resources please visit our website www.genomicseducation.hee.nhs.uk
Image by NHS HEE Genomics Education Programme
What Affects the Prognosis for Chronic Myelogenous Leukemia?
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
The patient’s age.
The phase of CML.
The amount of blasts in the blood or bone marrow.
The patient’s general health.
Source: PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (4)
Targeted Therapy
A summary of targeted therapy. Patients and their diseases are profiled in order to identify the most effective treatment for their specific case.
Image by Simon Caulton
Targeted Therapy
Image Caption : Antibody-dependent cell-mediated cytotoxicity. When the Fc receptors on natural killer (NK) cells interact with Fc regions of antibodies bound to cancer cells, the NK cell releases perforin and granzyme, leading to cancer cell apoptosis.
Image by Simon Caulton
Sensitive content
This media may include sensitive content
Hamartoma
Hamartoma of the spleen
Image by Photograph by Ed Uthman, MD.
Chronic Myeloid Leukemia (CML) | A Myeloproliferative Neoplasm (MPN) | Philadelphia Chromosome
Video by Medicosis Perfectionalis/YouTube
Targeted Therapy
Simon Caulton
Targeted Therapy
Simon Caulton
Sensitive content
This media may include sensitive content
Hamartoma
Photograph by Ed Uthman, MD.
17:59
Chronic Myeloid Leukemia (CML) | A Myeloproliferative Neoplasm (MPN) | Philadelphia Chromosome
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Chronic Myeloid Leukemia
Chronic myeloid leukemia is a slow-growing cancer of the blood-forming tissue (bone marrow), in which too many white blood cells are made. It usually affects older adults and rarely occurs in children. The condition consists of three phases: the chronic phase, the accelerated phase, and the blast phase. Learn about symptoms, genetics, and treatment.