I. INTRODUCTION AND POSSIBLE ETIOLOGIC FACTORS
Polycythemia vera in its numerous manifestations and course lends itself readily to a discussion of physiopathologic principles. Fundamentally, the disease may be considered as a disorder of the bone marrow characterized by an excessive production of blood cells by all the marrow elements, i. e., the nucleated red cells, the granulocytes and the megakaryocytes. To use Greek terms, there is panmyelopathy, which in turn results in pancytosis. The cause of the great and continuous blood production is obscure, but its results lead to many diverse manifestations which, as they are better understood, should lead to better control of the disease.A large body of knowledge has accumulated in recent years relating to the various substances required for erythropoiesis. Thus, iron, "liver extract factor" (now almost certainly vitamin B12), certain other constituents of the vitamin B complex, including folic acid, certain amino acids and
DAMESHEK W. PHYSIOPATHOLOGY AND COURSE OF POLYCYTHEMIA VERA AS RELATED TO THERAPY. JAMA. 1950;142(11):790–797. doi:10.1001/jama.1950.02910290018005
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