ABSTRACT

The chronic myeloproliferative disorders (MPDs) include a group of clonal stem cell disorders characterized by self-perpetuating and differentiating proliferation of seemingly only one of the myeloid lines in bone marrow. The anemic individual with striking red blood cell changes in the peripheral blood, documented marrow fibrosis, and significant splenomegaly is readily classified as having Anogenic myeloid metaplasia (AMM). Less obvious cases of AMM can be difficult to differentiate from other chronic MPDs. Distinguishing between ET and other chronic MPDs may be extremely difficult. Essential thrombocythemia (ET) is a distinctive primary clonal condition which hematologically and pathologically is one of the chronic MPDs. Patients with secondary polycythemia usually exhibit physical and laboratory findings different from patients with Polycythemia vera (PV). In sum, the diagnosis of PV requires obtaining a clinical history, physical exam, and appropriate studies. The serum uric acid in PV may be normal or increased, and patients may have secondary gout.