To help you understand ALL and its treatment, it’s useful to know a bit about your blood, how it’s made and what it does.
Blood is made up of blood cells, which float in a liquid called plasma. Blood cells are made in the bone marrow. This is a spongy material that’s found in the middle of our bones, particularly in our pelvis and backbone (spine). Normally, millions of new blood cells are made every day to replace old and worn-out blood cells.
All blood cells are made from cells called blood stem cells.
There are two types of blood stem cell:
- lymphoid stem cells, which make a type of white blood cells called lymphocytes
- myeloid stem cells, which make all the other types of blood cells: red blood cells, platelets and other white blood cells.
Blood stem cells in the bone marrow divide and grow to make new blood cells. The new, immature, blood cells are called blast cells. They don’t look like mature cells and they can’t do the jobs that mature cells do. Usually, blast cells stay in the bone marrow until they have matured into red blood cells, platelets or white blood cells.
The mature cells are then released into your blood to carry out different functions:
- Red blood cells contain haemoglobin (Hb), which carries oxygen from your lungs to all the cells in your body.
- Platelets are very small cells that help blood to clot, and prevent bleeding and bruising.
- White blood cells fight and prevent infection. There are several types of white blood cell. The two most important types are neutrophils and lymphocytes.
The levels of these cells in your blood are measured in a blood test called a full blood count (FBC). The figures below are a guide to the levels usually found in a healthy person.
|Type of cell||Levels found in a healthy person|
|Red blood cells (Hb)||130–180g/l (men)|
|Platelets||150–400 x 109/l|
|White blood cells (WBC)||4.0–11.0 x 109/l|
|Neutrophils||2.0–7.5 x 109/l|
|Lymphocytes||1.5–4.5 x 109/l|
These figures can vary from hospital to hospital. Your doctor or nurse will be able to tell you what levels they use. They can also vary slightly between people from different ethnic groups.
The figures might look complicated when they’re written down, but in practice they are used in a straightforward way. For example, you’ll hear doctors or nurses saying things like ‘your haemoglobin is 140’ or ‘your neutrophils are 4’.
Most people with ALL soon get used to these figures and what they mean. But remember, you can always ask your medical team for further explanation if you need it.