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January 6, 1940

THE REACTION OF PERIPHERAL BLOOD AND BONE MARROW: IN CHRONIC HEMORRHAGE AND IN ESSENTIAL THROMBOPENIC PURPURA

JAMA. 1940;114(1):12-18. doi:10.1001/jama.1940.02810010014003
Abstract

The circulating cellular elements in the peripheral blood are dependent largely on a normal maturation process in the bone marrow. If this is disturbed, disease results. Thus granulocytopenia is associated with a maturation arrest of the myeloid tissue and pernicious anemia with a disturbance in the maturation process of the erythroid tissue.

It has been noted in essential thrombopenic purpura that there is a hyperplasia of the megakaryocytic tissue which is associated with a reduction in the number of platelets in the peripheral blood and with abnormalities in platelet size. This has led to two interpretations of the mechanism of the disease. By some the primary defect is attributed to a failure in the maturation of the megakaryocyte.1 The cell does not reach sufficient maturity to form platelets. By others the hyperplasia is attributed to a compensatory response to excessive destruction of platelets in the peripheral blood.2 In

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