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Identification of masked polycythemia vera from patients with idiopathic
marked thrombocytosis by endogenous erythroid colony assay
LY Shih and CT Lee
Department of Internal Medicine, Chang Gung Medical College, Chang Gung
Memorial Hospital, Taipei, Taiwan, ROC.
We used the methylcellulose-culture technique to determine the utility of
the erythroid progenitor growth in vitro from nonadherent T-depleted bone
marrow and peripheral blood cells in distinguishing polycythemia vera (PV)
from essential thrombocythemia. Thirty patients with PV (group A) and 30
patients who presented with idiopathic marked thrombocytosis with platelet
count greater than 1,000 x 10(9)/L and a normal or reduced hemoglobin (Hb)
level (group B) were studied at initial presentation. Endogenous
(erythropoietin-independent) erythroid colonies (EEC) were found in all
patients in group A and 13 in group B. The numbers of EEC were comparable
between patients in group A and the 13 patients with EEC in group B, 11 of
whom with initial Hb levels ranging between 6.4 g/dL and 12.6 g/dL were
found to have PV 2 to 45 months after initial evaluation. The number of EEC
did not correlate with the time to the progression of polycythemia, whereas
myelosuppression delayed the subsequent development of PV. Of the two
patients with EEC in group B who did not develop PV, both received
chemotherapy soon after presentation, which might preclude the evidence of
polycythemia evolution. None of the other patients in group B who did not
form EEC developed PV with a median follow-up of 24 months. This study
indicates that the assessment of EEC in bone marrow or blood is helpful in
early identification of PV or prediction of polycythemia evolution in
patients with marked thrombocytosis in whom polycythemia has been initially
masked or anemia is present.
Volume 83,
Issue 3,
pp. 744-748,
02/01/1994
Copyright © 1994 by The American Society of Hematology
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