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White Blood Cells and Immunity 11
KNOWLEDGE GOALS
• White blood cells • Immunity
• Leucopoiesis • Cytokines
• Phagocytosis • Tissue transplantation
• Lymphoid organs and MHC

Granulocytes (neutrophils, eosinophils, baso-

WHITE BLOOD CELLS
phils) and agranulocytes (lymphocytes, monocytes)
The white blood cells or WBCs (Figs. 11-1, 11-2 Normal count—4000–11,000 cells/mm3
and Table 11-1) are divided as: Eosinophils as anti larvicidal—Eosinophils
have anti parasitic action too, that is effective

Figure 11-1 Representation of various WBCs. [Source: Clinical Procedures for Medical Assistants. 2008. Figure 18-3,
Types of human blood cells. 1 to 7, White blood cells (leukocytes) stained as they are in the laboratory to show the many types.
They play the active role in immune response or in defense against disease. 1, neutrophil; 2, neutrophilic band; 3, eosinophil; 4,
basophil; 5, lymphocyte; 6, (large) lymphocyte; 7, monocyte; 8, platelets (thrombocytes), which are responsible for clotting; 9,
red blood cells (erythrocytes), which carry oxygen.]

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94 SECTION II — BLOOD

against the larvae of some parasites which are big

enough to be engulfed. Eosinophils get attached
to these and some hydrolytic enzymes (oxygen
free radicals) and anti larvicidal agents (major ba-
sic protein—MBP) are released by their granules,
which destroy the parasites.
Though eosinophils and basophils have opposite ac-
tions in allergic reactions, still they act in a balanced
way to manage the condition.

POINT TO REMEMBER
Monocyte is the largest blood cell

STAGES OF LIFE OF NEUTROPHILS

Neutrophils are in bone marrow pool, from
Figure 11-2 Percentage of various WBCs in circulation. where 50% reach margination pool and rest 50%

Table 11-1 Various white blood cells

Differential Diameter
WBCs Count (%) (µm) Nucleus Cytoplasm Functions
Neutrophils 50%–70% 10–14 Bluish violet, 2–6 Slate bluish colour, fine Phagocytosis (1st line of defence),
lobed, connected violet pinkish granules contain endogenous pyrogens
by chromatin giving ground glass (fever inducing substance)
threads appearance, not
covering nucleus
Eosinophils 1%–4% 10–14 Bluish violet, Light pinkish Mild phagocytosis, limit allergic
spectacle shaped eosinophilic, large, reactions, anti parasitic action*,
course brick red provide mucosal immunity
colour granules, not
covering nucleus
Basophils <1% 10–14 Bluish violet, Bluish, basophilic, Mild phagocytosis, release heparin,
irregular or S deep purple histamine and serotonin, promotion
shaped granules completely of inflammatory reactions as they
covering and release histamine, serotonin,
distorting nucleus eosinophilic chemotactic factor,
bradykinin and various other
chemicals at site of allergy
Lymphocytes 20%–40% Large Single deep bluish Large light blue, rim Antibody production and immune
lymphocytes: violet, almost of cresentric clear response
10–14 filling cell, can be cytoplasm, no
central or eccentric granules visible
Small Single deep bluish Thin rim of light blue
lymphocytes: violet, ink dot cytoplasm, no
7–10 appearance due to granules visible
condensed, lumpy
chromatin
Monocytes 2%–8% 14–18 Pale bluish violet, Abundant bluish Phagocytosis (2nd line of defence),
kidney or bean cytoplasm, no converted to macrophages on
shaped, eccentric granules visible entering circulation, kill tumour
cells, part of monocyte macrophage
system (MMS)/reticuloendothelial
system (RES)—after spending
1–2 days in circulation monocytes
enter the tissues increase in size
and become tissue macrophages
having phagocytic action

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 CHAPTER 11 — White Blood Cells and Immunity 95

Figure 11-3 Stages of life of neutrophil.

enter circulation pool and finally reach the tissues Feedback mechanism involved in regulation of
(Fig. 11-3). leucopoiesis

LEUCOPOIESIS

Formation of a WBC, that is process of differen-

tiation of primitive stem cells to committed stem
cells which further differentiate into myeloid
series leading to development of several WBCs
(Figs. 11-4–11-6). Granulocytes are formed by the
steps mentioned below:

Figure 11-4 Stages in leucopoiesis.

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96 SECTION II — BLOOD

Figure 11-5 Granulopoiesis and monocytopoiesis.

Leucopenia—Fall in WBC count to <4,000 cells/

mm3 (Table 11-2).
Increase or decrease in individual WBCs or the
differential variations are tabulated in Table 11-3.

LEUKAEMIA

Leukaemia refers to malignant neoplasia of hae-

mopoietic cells, which begins in bone marrow,
associated with abnormal proliferation of leuco-
cytes and their precursors resulting in appearance
of abnormal and immature cells in peripheral
blood, associated leucocytosis and tissue infiltra-
tion by the leukaemic cells. Commonly, leukae-
mias are referred as blood cancers. It can be of
Figure 11-6 Lymphopoiesis. myeloid series (mostly involving neutrophils) and
lymphoid series (involving lymphocytes).

CONDITIONS AFFECTING WBC COUNT TYPES OF LEUKAEMIAS

Leucocytosis—Increase in WBC count beyond 1. Acute myeloid leukaemia (AML)—Common in
11,000/mm3. This is the normal defensive reaction adult males
of body towards various types of stresses, for exam- 2. Chronic myeloid leukaemia (CML)—Common
ple exercise, infections, surgery, injury etc. in adults and associated with chromosomal

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