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June 20, 1936


JAMA. 1936;106(25):2177-2178. doi:10.1001/jama.1936.02770250061023

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To the Editor:—  The editorial on "Granulocytopenia, Malignant Neutropenia or Agranulocytosis" published in The Journal, April 25, fails to mention a number of recent articles which have gone far to elucidate some of the mechanisms involved in production of the disease in question.Most investigators have now accepted the theory first enunciated by Fitz-Hugh and Krumbhaar that the bone marrow of the disease is characterized by a state of "maturation arrest" of the white cells, in which, although the marrow is well stocked with primitive leukocytes ready to mature, the peripheral blood shows depletion of granulocytes. The most complete of recent publications demonstrating this feature is that of R. C. Darling, Frederic Parker Jr. and Henry Jackson Jr. (Am. J. Path 12:1 [Jan.] 1936). These authors point out from study of their large material (mostly biopsies from sternal bone marrow) that the disorder has a rather consistent pathologic picture, which

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