The erythrocytes, or red blood cells, make up the largest population of blood cells, numbering from 4.5 million to 6 million per cubic millimeter of blood. They carry out the exchange of oxygen and carbon dioxide between the lungs and the body tissues. To effectively combine with oxygen, the erythrocytes must contain a normal amount of the red protein pigment hemoglobin, the amount of which in turn depends on the iron level in the body. A deficiency of iron and therefore of hemoglobin leads to anemia and poor oxygenation of the body tissues.
Erythrocytes are constantly developing from stem cells, the undifferentiated, self-regenerating cells that give rise to both erythrocytes and leukocytes in the bone marrow. In the fetus, red blood cells are produced in the spleen. As they mature, the erythrocytes lose their nuclei, become disk-shaped, and begin to produce hemoglobin. After circulating for about 120 days, the erythrocytes wear out and undergo destruction by the spleen. Although all red blood cells are essentially similar, certain structures on their surfaces vary from person to person. These serve as the basis for the classification into blood groups. There are four major blood groups, whose compatibility or incompatibility is an important consideration in successful blood transfusion.
The leukocytes, or white blood cells, defend the body against infecting organisms and foreign agents, both in the tissues and in the bloodstream itself (see immunity). Human blood contains about 5,000 to 10,000 leukocytes per cubic millimeter; the number increases in the presence of infection. An extraordinary and prolonged proliferation of leukocytes is known as leukemia. This overproduction suppresses the production of normal blood cells. Conversely, a sharp decrease in the number of leukocytes (leukopenia) strips the blood of its defense against infection and is an equally serious condition. A dramatic fall in levels of certain white blood cells occurs in persons with AIDS. Leukocytes as well as erythrocytes are formed from stem cells in the bone marrow.
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