Helen Ashenbrucker

Leukokinetic Studies. XI. Blood Granulocyte Kinetics in Polycythemia Vera, Infection, and Myelofibrosis

Although it seems evident that the neutrophilic leukocytosis commonly encountered in patients with purulent infections, polycythemia rubra vera, and a variety of other clinical disorders probably indicates an increased mass of neutrophils in the blood and increased neutrophil production, turnover, and utilization, it has not been possible to quantify these processes directly until recently. In normal subjects it was demonstrated that approximately one-half of the neutrophilic granulocytes in the blood are circulating freely [circulating granulocyte pool (CGP)], whereas the remainder adhere to the walls of small venules [marginal granulocyte pool (MGP)] (1). Since these two pools were shown to be in rapid equilibrium with each other they may be considered to form a single total blood granulocyte pool (TBGP) for kinetic purposes. These facts together with the finding that neutrophilic granulocytes disappear from the blood in a random manner (2) have made it possible to approximate the rate of production and destruction of neutrophils in normal man. In the present study the size of the TBGP, the distribution of cells in the two subcompartments, the CGP and the MGP, the blood granulocyte half disappearance time (tj), and the granulocyte turnover rate (GTR) were measured in patients with polycythemia vera, myelofibrosis, chronic infections, and diseases of other kinds. Studies in patients with chronic myelocytic leukemia are the