ANATOMY AND

PHYSIOLOGY
The immune system defends the body
from invading organisms that may
cause disease. One part of the immune
system uses barriers to protect the
body from foreign substances. These
barriers include the skin and the
mucous membranes, which line all
body cavities; and protective
chemicals, such as enzymes in saliva
and tears that destroy bacteria.
Another part of the immune system
uses lymphocytes, specialized white
blood cells that respond to specific
types of foreign invaders. B-
lymphocytes produce proteins called
antibodies, which circulate in the
blood and attack specific disease-
causing organisms. T lymphocytes
attack invading organisms directly.
COMPONENTS OF THE
IMMUNE SYSTEM
Macrophage Engulfing Bacterium
A macrophage, in yellow, engulfs and
consumes a bacterium. Macrophages
are large phagocytes, cells that
wander through the body consuming
foreign particles such as dust,
asbestos particles, and bacteria. They
help protect the body against
infection.
White blood cells are the mainstay of
the immune system. Some white
blood cells, known as
Macrophages, play a function in
innate immunity by surrounding,
ingesting, and destroying invading
bacteria and other foreign organisms
in a process called phagocytosis,
which is part of the inflammatory
reaction.
Macrophages also play an
important role in adaptive
immunity in that they attach to
invading antigens and deliver
them to be destroyed by other
components of the adaptive
immune system.
BONE MARROW
Bone Marrow, a soft, pulpy tissue that
fills the cavities of bones, occurring in
two forms, red and yellow. One of the
largest tissues in the body, bone
marrow accounts for 2 to 5 percent of
an adult’s weight. Red marrow,
present in all bones at birth, serves as
the blood manufacturing center.
As an infant matures, most of the
red marrow in the shaft of long
bones, such as the arm and leg
bones, is gradually replaced by
yellow marrow. Yellow marrow
is composed primarily of
specialized fat cells.
BLOOD
Blood is one of the connective tissues.
As a connective tissue, it consists of
cells and cell fragments (formed
elements) suspended in an intercellular
matrix (plasma). Blood is the only
liquid tissue in the body that measures
about 5 liters in the adult human and
accounts for 8 percent of the body
weight.
Blood is the only liquid tissue in
the body that measures about 5
liters in the adult human and
accounts for 8 percent of the
body weight. The body consists
of metabolically active cells that
need a continuous supply of
nutrients and oxygen.
Metabolic waste products need to be
removed from the cells to maintain a
stable cellular environment. Blood is
the primary transport medium that is
responsible for meeting these cellular
demands. Blood cells are formed
in the bone marrow, the soft, spongy
center of bones. New (immature)blood
cells are called blasts. Some blasts stay
in the marrow to mature.
The body consists of metabolically
active cells that need a continuous
supply of nutrients and oxygen.
The activities of the blood may be
categorized as transportation,
regulation, and protection. These
functional categories overlap and
interact as the blood carries out its
role in providing suitable conditions
for cellular functions.
LYMPHOCYTE
Lymphocytes are specialized white
blood cells whose function is to
identify and destroy invading
antigens. All lymphocytes begin as
“stem cells” in the bone marrow, the
soft tissue that fills most bone
cavities, but they mature in two
different places.
Some lymphocytes mature in the bone
marrow and are called B
lymphocytes. B lymphocytes, or B
cells, make antibodies, which
circulate through the blood and other
body fluids, binding to antigens and
helping to destroy them in immune
responses.
Other lymphocytes, called T
lymphocytes, or T cells, mature in the
thymus, a small glandular organ located
behind the breastbone.
Some T lymphocytes, called cytotox ic
(cell-poisoning) or killer T lymphocytes,
generate cell-mediated immune
responses, directly destroying cells that
have specific antigens on their surface
that are recognized by the killer T cells. 
Helper T lymphocytes, a second kind
of T lymphocyte, regulate the immune
system by controlling the strength and
quality of all immune responses. Most
contact between antigens and
lymphocytes occurs in the lymphoid
organ; the lymph nodes, spleen, and
tonsils, as well as specialized areas of
the intestine and lungs.
. Mature lymphocytes constantly travel
through the blood to the lymphoid
organs and then back to the blood
again. This recirculation ensures that
the body is continuously monitored
for invading substances
MANAGEMENT
Chemotherapy
Chemotherapy is the major form of
remission induction therapy. A common
course of therapy involves two
chemotherapy drugs; cytarabine (Cytosar-
U), followed by ananthracycline drug,
such as daunorubicin (Cerubidine) or
idarubicin (Idamycin). A third
medication, thioguanine, is sometimes
used.
Bone marrow transplant
This is another option for consolidation
therapy for people at high risk of
relapse or for treating relapse when it
occurs. This procedure allows
someone with leukemia establish
healthy stem cells by replacing their
leukemic bone marrow with leukemia
free- marrow.
If you choose this treatment, you'll
receive very high doses of chemotherapy
or radiation therapy to destroy your
leukemia-producing bone marrow. This
marrow is then replaced by bone marrow
from a compatible donor. In some cases,
you may also be able to use your own
bone marrow for transplant. This is
possible if you go intoremission and then
save healthy bone marrow for a future
transplant.
Stem cell transplant
 Stem cell transplant is also used for
consolidation therapy. It's similar to
bone marrow transplant except the
stem cells are collected from
circulating blood (peripheral blood),
rather than from the bone marrow,
thanks to a medication that causes
larger numbers of stem cells to be
released from the bone marrow.
The cells used for transplant can be
your own healthy cells, or they can
be collected from a compatible
donor. This procedure is used more
frequently than bone marrow
transplant because of shortened
recovery times and possible
decreased risk of
leukemia recurrence
Radiation Therapy
Radiation therapy involves the use
of radiation to kill cancer cells and
shrink tumors.