Hematopoietic Cascade Pluripotent Stem Cell IL-1 SCF IL-6 Flt3L IL-3 IL-11 TPO Myeloid Stem Cell GM-CSF IL-3 Flt3L SCF IL-7 G-CSF Lymphoid Stem Cell CFU-BLAST SCF Flt3L IL-1 IL-6 IL-7 Flt3L SCF GM-CSF IL-11 IL-6 TPO IL-3 Flt3L SCF GM-CSF IL-3 CFU-GEMM GM-CSF BFU-MK CFU-G CFU-GM GM-CSF IL-3 IL-6 IL-11 TPO SCF Flt3L Myeloblast GM-CSF G-CSF CFU-E CFU-MK Neutrophilic Myelocyte GM-CSF G-CSF TPO EPO IL-3 SCF GM-CSF IL-3 TPO IL-11 IL-6 GM-CSF IL-3 SCF Flt3L TNF IL-7 Flt3L CFU-M/DC CFU-Eo GM-CSF IL-5 IL-3 GM-CSF M-CSF IL-3 CFU-Bas GM-CSF Flt3L TNF SCF IL-4 GM-CSF M-CSF IL-3 GM-CSF IL-5 IL-3 Eosinophilic Myelocyte Promonocyte GM-CSF M-CSF IL-3 GM-CSF IL-5 IL-3 E. Metamyelocyte GM-CSF G-CSF EPO TPO IL-11 IL-6 GM-CSF IL-5 IL-3 Monocyte Band Neutrophil GM-CSF M-CSF IFN Band Eosinophil GM-CSF IL-5 IL-3 Neutrophil © 2009 Genzyme Corporation. All rights reserved LEU/US/P023/0709 Printed in USA July 2009 Macrophage Myeloid-related Dendritic Cell Eosinophil Flt3L IL-7 Flt3L IL-15 CFU-Mast NK Precursor IL-3 Pre B Cell Prothymocyte IL-7 IL-7 IL-15 B Lymphoblast T Lymphoblast Antigen Driven Antigen Driven Myeloblast Flt3L IL-1 IL-3 IL-6 IL-7 IL-10 SCF G-CSF IL-15 IL-3 Basophilic Myelocyte SCF IL-3 Mature NK Cell (I) Flt3L IL-7 IL-15 IL-2 IFN IL-3 T Cell B. Metamyelocyte IL-3 Mature NK Cell (II) GM-CSF IL-4 IL-1 IL-6 IL-12 TNF Platelets DC Stem Cell Lymphoid-related Dendritic Cell GM-CSF G-CSF Erythrocyte T Stem Cell Myeloblast Monoblast N. Metamyelocyte Megakaryocyte G-CSF IL-7 Progenitor B Cell Proerythroblast IL-1 IL-6 IL-3 SCF B Stem Cell GM-CSF G-CSF GM-CSF IL-3 SCF EPO SCF Flt3L IL-6 IL-7 IL-3 GM-CSF IL-3 SCF Flt3L BFU-E GM-CSF IL-3 IL-1 IL-2 Plasma Cell Band Basophil IL-3 Basophil Mast Cell Legend Pluripotent Stem Cell: The most primitive blood-forming cell, primarily found in the bone marrow with small proportions found in the blood and spleen. This cell has extensive self-renewal capabilities and differentiates into lymphoid stem cells and myeloid stem cells (CFU-GEMM). Myeloid Stem Cell/CFU-GEMM (Colony-Forming Unit- Granulocyte, Erythroid, Macrophage, Megakaryocyte): Primitive blood-forming cell with extensive proliferative capacity that differentiates into the committed precursors of granulocytes (basophils, eosinophils, mast cells, and neutrophils), red blood cells, monocyte/macrophages, dendritic cells, and platelets. BFU-E/Burst-Forming Unit – Erythroid: The most primitive committed progenitor of red blood cells. This cell has extensive proliferative capacity and differentiates into CFU-E. BFU-MK/Burst-Forming Unit – Megakaryocyte: The most primitive committed precursor of platelets. This cell has high proliferative capacity and differentiates into CFU-MK. CFU-Bas/Colony-Forming Unit – Basophil: Committed precursor of basophils with limited proliferative capacity. CFU-E/Colony-Forming Unit – Erythroid: Committed precursor of red blood cells with limited proliferative capacity. CFU-Eo/Colony-Forming Unit – Eosinophil: Committed precursor of eosinophils with limited proliferative capacity. CFU-G/Colony-Forming Unit – Granulocyte: Committed precursor of granulocytes with limited proliferative capacity. CFU-GM/Colony-Forming Unit – Granulocyte-Macrophage: Committed precursor of granulocytes, monocytes/macrophages, and dendritic cells with limited proliferative capacity. CFU-M/DC/Colony-Forming Unit – Monocyte/Dendritic Cell: Committed precursor of monocytes/macrophages and dendritic cells with limited proliferative capacity. CFU-Mast/Colony-Forming Unit – Mast Cell: Committed precursor of mast cells with limited proliferative capacity. CFU-MK/Colony-Forming Unit – Megakaryocyte: Committed precursor of platelets with limited proliferative capacity. Band Neutrophil: Neutrophil precursor that develops from neutrophilic metamyelocyte. Characterized by horse shoe shaped nuclei. Basophil: White blood cell involved in inflammatory and anti-parasitic responses. Basophils make up about 0.5% of the white blood cell count. Basophilic Myelocyte: Immature cell that develops into a basophil. Dendritic Cell: Professional antigen-presenting cell responsible for induction of primary antigen-specific immune response. E Metamyelocyte: Eosinophil precursor that develops from eosinophilic myelocyte. Characterized by bean shaped nuclei and eosinophilic granules. Eosinophil: White blood cell important in anti-parasitic defense. Makes up 1%-3% of the white blood cell count. Platelet: Circulating cell important in the clotting process. IL-18: Upregulates IFN production; enhances NK-cell cytotoxicity Proerythroblast: Immature cell that develops into a red blood cell, or erythrocyte. IFN (Interferon): Stimulates macrophage and NK-cell activity; stimulates T-cell growth and differentiation; provides direct antitumor effects Promonocyte: Immature cell that develops into a monocyte. T Cell: Mature lymphoid cell responsible for control of the immune response. Includes T-suppressor, T-helper, and T-cytotoxic “killer” cells. Found in spleen, blood, and lymphatic system. T Lymphoblast: Immature cell that develops into a T cell. FACTORS EPO: Erythropoietin TPO: Thrombopoietin Erythrocyte: Red blood cell responsible for oxygen transport. G-CSF: Granulocyte Colony-Stimulating Factor Lymphoid Stem Cell: Stem cell that upon differentiation gives rise to lymphocytes. Includes B, T, and DC stem cells. M-CSF: Macrophage Colony-Stimulating Factor Mast Cell: White blood cell that proliferates during inflammatory response. Found in connective tissues and plays a role in allergic reactions. IL-1: Upregulates adhesion molecule expression and neutrophil and macrophage emigration; raises body temperature; facilitates hematopoiesis IL-2: Stimulates T-cell activation and proliferation, B-cell growth, and NK-cell proliferation and activation IL-3: Promotes proliferation of hematopoietic progenitor cells Megakaryocyte: Large multi-nucleated cell from which platelets are derived. IL-4: Stimulates differentiation and proliferation of TH2 helper T-cells; stimulates B-cell Ig class switch to IgG1 and IgE Monoblast: Immature cell that ultimately gives rise to a monocyte. IL-5: Stimulates B-cell growth and eosinophil differentiation and proliferation Monocyte: Phagocytic cell that circulates in the bloodstream for 1-2 days. Upon migration to tissues, differentiates into the more phagocytic macrophage. Myeloblast: Immature cell that ultimately gives rise to a neutrophil. N Metamyelocyte: Neutrophil precursor that develops from neutrophilic myelocyte. Characterized by bean shaped nuclei and neutrophilic granules. Akashi K, Traver D, Miyamoto T, Weissman I. A clonogenic common myeloid progenitor that gives rise to all myeloid lineages. Nature. 2000;404:193-197. Arinobu Y, Iwasaki H, Akashi K. Origin of basophils and mast cells. Allergol Int. 2009;58(1):21-8. Arinobu, Y, Iwasaki H, Gurish MF, Mizuno S, Shigematsu H, Ozawa H, Tenen DG, Austen KF, Akashi K. Developmental checkpoints of the basophil/mast cell lineages in adult murine hematopoiesis. Proc Natl Acad Sci USA. 2005;102(50):18105–18110. Blom B, Spits H. Development of Human Lymphoid Cells. Annu. Rev. Immunol. 2006; 24:287–320. Bondurant M, Koury M. Origin and development of blood cells. In: Greer J, Foerster J, Rodgers G, Paraskevas F, Glader B, Foerster J, Lukens J, eds. Wintrobe’s Clinical Hematology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:170. Hirayama F, Ogawa M. Cytokine regulation of early lymphohematopoietic development. Stem Cells.1996;14(4):369-75. Hoffman R, Murray L, Young J, Luens K, Bruno E. Hierarchical Structure of Human Megakaryocyte Progenitor Cells. Stem Cells. 1996;14(suppl 1):75-81. Jacobsen SE, Borge OJ, Ramsfjell V, Cui L, Cardier JE, Veiby OP, Murphy MJ Jr, Lok S. Thrombopoietin, a direct stimulator of viability and multilineage growth of primitive bone marrow progenitor cells. Stem Cells. 1996;14 Suppl 1:173-80. Kaushansky K. Lineage-specific hematopoietic growth factors. N Engl J Med. 2006;354(19): 2034-2045. IL-7: Promotes differentiation of B-, T-, and NK-cell precursors and activation of T and NK cells Kent D, Copley M, Benz C, Dykstra B, Bowie M, Eaves C. Regulation of hematopoietic stem cells by the steel factor/KIT signaling pathway. Clin Cancer Res. 2008;14(7):1926-30. IL-10: Inhibits macrophage proinflammatory cytokine production; downregulates cytokine class II antigen and B7-1 and B7-2 expression; inhibits differentiation of TH1 T-helper cells; inhibits NK-cell function; stimulates mast cell proliferation and function and B-cell activation and differentiation Kikushige Y, Yoshimoto G, Miyamoto T, et al. Human flt3 is expressed at the hematopoietic stem cell and the granulocyte/macrophage progenitor stages to maintain cell survival. J Immunol. IL-11: Key regulator of multiple events in hematopoiesis, most notably the stimulation of megakaryocyte maturation Mori Y, Iwasaki H, Kohno K, Yoshimoto G, Kikushige Y, Okeda A, Uike N, Niiro H, Takenaka K, Nagafuji K, Miyamoto T, Harada M, Takatsu K, Akashi K. Identification of the human eosinophil lineage-committed progenitor: revision of phenotypic definition of the human common myeloid progenitor. J Exp Med. 2009;206(1):183-93. B Metamyelocyte: Basophil precursor that develops from basophilic myelocyte. Characterized by bean shaped nuclei and basophilic granules. Neutrophil: White blood cell capable of phagocytosis, chemotaxis, and adherence to immune complexes. Accounts for 60%-70% of the white blood cell count. IL-12: Secreted by activated macrophages, IL-12 induces TH1 T-helper cell formation and lymphokine-activated killer cell formation; increases CD8+CTL activity Band Basophil: Immediate precursor of mature basophil that develops from basophilic metamyelocyte. Characterized by horse shoe shaped nuclei. Neutrophilic Myelocyte: Immature cell that develops into a neutrophil. IL-15: Stimulates T-cell activation and proliferation; promotes cytogenesis and NK cells Band Eosinophil: Immediate precursor of mature eosinophils that develops from eosinophilic metamyelocyte. Characterized by horse shoe shaped nuclei. REFERENCES Kaushansky K. Hemopoeitic stem cells, progenitors and cytokines. In: Beutler E, Lichtman M, Kaushansky K, Prchal J, Kipps T, Seligsohn U, eds. Williams Hematology. 7th ed. New York, NY: McGraw-Hill; 2006:202. B Lymphoblast: Immature cell that develops into a B cell. Plasma Cell: B cell that manufactures immunoglobulins. Flt3L: Ligand for Flt3 receptor IL-6: Provokes a broad range of cellular and physiological responses and plays a role in inflammation and hematopoiesis Natural Killer (NK) Cells: Large granular lymphocyte which does not express markers of either T or B cell lineage. These cells primarily kill target cells using antibody-dependent cell-mediated cytotoxicity; however, other processes can be used to kill cells in the absence of an antibody. Killing may occur without previous sensitization. B Cell: Mature lymphoid cell involved in humoral immunity, capable of differentiating into plasma cells that produce antibodies. B cells are found in the spleen, blood, and lymphatic system. SCF: Stem cell factor, ligand for c-kit receptor GM-CSF: Granulocyte-Macrophage Colony-Stimulating Factor Eosinophilic Myelocyte: Immature cell that develops into an eosinophil. Macrophage: Phagocytic cell found in the tissues that is able to kill bacteria, parasites, and fungi. Functions as an antigen-presenting cell and regulates the inflammatory response. TNF (Tumor Necrosis Factor): Promotes fever, anorexia, shock, capillary leak syndrome, enhanced leukocyte cytotoxicity, and enhanced NK-cell function Majka, M, Janowska-Wieczorek A, Ratajczak J, Ehrenman K, Pietrzkowski Z, Kowalska A, Gewirtz G, Emerson SG, Ratajczak MZ. Numerous growth factors, cytokines, and chemokines are secreted by human CD341 cells, myeloblasts, erythroblasts, and megakaryoblasts and regulate normal hematopoiesis in an autocrine/paracrine manner. Blood. 2001; 97(10):3075-3085. 2008;180(11):7358–7367. Ogawa M. Differentiation and proliferation of hematopoietic stem cells. Blood. 1993;81(11):2844-2853. Williams D, Bunn HF, Sieff C, Zon L. Hematopoiesis. In: Handin R, Lux S, Stossel T, eds. Blood: principles and practice of hematology. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:181.