Blood, Anemia, Leukemia, and Blood Tests

Blood, Anemia, Leukemia & Blood Tests Chapter Overview

William Wang and Jennifer Kong

Chapter Learning Objectives

By the end of this chapter, you will be able to:

  • Identify the primary functions of blood in transportation, defense, and maintenance of homeostasis
  • Name the fluid and cellular components of blood and identify their relative proportions in a blood sample
  • Identify the composition of blood plasma, including its most important solutes and plasma proteins
  • Describe how anemia can develop, its classification, appearance in peripheral blood smears, and treatment
  • Briefly explain how leukemia can develop, its classification, appearance in peripheral blood smears and bone marrow biopsies,  and treatment
  • Compare and contrast the signs and symptoms of anemia and leukemia
  • List the specialties of medical laboratory sciences and the tests they do with blood
  • Explain the blood test iron studies and how it is related to the diagnosis of anemia
  • Briefly describe the journey a blood sample takes in LifeLabs, when being analyzed for hematology and blood chemistry tests
a black and white picture of an electron microscope image of a donut-shaped red blood cell, the much smaller platelet with appendages, and a white blood cell covered in surface features
Figure 11.1  Blood Cells 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.

Blood is essential for life: it delivers all the oxygen and nutrients the tissues need and removes their wastes. The cellular components of blood—referred to as the formed elements—include red blood cells (RBCs), white blood cells (WBCs), and cell fragments called platelets. Plasma, which is mostly water, suspends the formed elements and carries within it everything that is water soluble (e.g., nutrients and electrolytes). Together, the plasma and formed elements circulate throughout the body as part of the cardiovascular system.

Blood disorders are often associated with disorders of the formed elements. Anemia is a blood disorder involving the abnormal synthesis of RBCs and/or hemoglobin. Anemia is quite common in the population due to a variety of causes.

In contrast, blood cancers – called leukemias – involve an inability to produce mature blood cells from the bone marrow. Leukemias involve the overproduction of abnormal, immature blood cells – called blasts – which crowd out and replace the growth an maturation of blood cells. Leukemias can be subclassified based on the blood stem cell that is abnormally proliferating (lymphoid vs myeloid stem cell) and whether the leukemia develops suddenly (i.e. acute) or long term (i.e. chronic)

From a health care perspective, blood tests are a common part of investigations. However, ‘blood tests’ are actually subdivided (like blood itself) into tests for either the number/quality of mature blood cells (e.g. hematology test will look at the number of RBC, WBC, and platelets) or tests for the content within plasma (E.g. chemistry test will look at amount of glucose and electrolytes within the plasma part of blood). Taken together, these test results can give signs of organ dysfunction, along with a snapshot of a person’s ability to carry oxygen, nutrients, electrolytes.

This chapter is subdivided into:

  • Pre-test
  • Normal blood production and function (including histology of normal bone marrow & peripheral blood)
  • Classification of anemia and leukemia
  • Pathophysiology and hematopathology of anemia and acute leukemia
  • Interviews with health care professionals diagnosing/treating those with leukemia and discussions its complications
      • Hematopathologist
      • Medical laboratory science technologists (hematology & clinical chemistry)
  • Videotour of LifeLabs facility:  the largest processor of blood tests in Western Canada.
  • Post-test


The following abbreviations are used throughout the chapter.

ALL = acute lymphoblastic leukemia

Fe = iron

Hb = hemoglobin

Hct = hematocrit

LIS = laboratory Info system

MCH = mean cell hemoglobin

MCHC = mean cell hemoglobin concentration

MCV = mean cell volume

MLA = medical lab assistant

MLT = medical lab technologist

O2 = oxygen

PCR = polymerase chain reaction

ROI = region of interest

RBC = red blood cell

TIBC = total iron binding capacity

WBC = white blood cell




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Pathology Copyright © 2022 by William Wang and Jennifer Kong is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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