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

Abstract

Sixty studies of blood granulocyte kinetics have been carried out by means of the in-vitro, diisopropylfluorophosphate (DEP32)-labeled granulocyte technic in patients with polycythemia rubra vera, subacute and chronic infection, myelofibrosis, and miscellaneous diseases. The results are compared with values in 56 normal subjects. An increase in total blood granulocyte pool size was observed in all subjects with blood granulocyte counts persistently greater than 10,000 per mm3 . In 8 of 16 patients with normal total blood granulocyte pools (TBGP) the granulocyte count was moderately elevated (7,500 to 9,890) and in 3 patients with moderately elevated TBGP the granulocyte concentration was within normal limits. These last two groups of studies presumably reflect intravascular shifts in granulocyte distribution. In patients with myelofibrosis and in some patients with polycythemia rubra vera there was a tendency for the granulocytes to accumulate disproportionately in marginal sites, and this tendency was particularly noticeable when the total blood granulocyte pool values were high. In all but 4 of the 60 studies the t 1/2 values were normal or moderately increased. In no study was the t 1/2 less than normal. The daily granulocyte turnover rate ranged from normal to twelve times normal. The increase in granulocyte turnover rate in these studies appears to be associated with an increase in the size of the total blood granulocyte pool rather than an accelerated blood granulocyte pool renewal rate. In 4 studies on patients with myelofibrosis very long t 1/2 values of 30 to 50 hours were found. These values are comparable to those encountered in patients with chronic myelocytic leukemia in relapse.