Polycythaemia Following Splenectomy in Myelofibrosis with Myeloid Metaplasia. A Reorganization of Erythropoiesis

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Abstract
Three patients with myelofibrosis with myeloid metaplasia were splenetomized because of anemia and disturbing splenomegaly. In the course of the 6 mo. following splenectomy, a polycythemia developed. Erythrokinetic studies demonstrated that in all cases a reduction in plasma volume and an increase in red cell volume was obtained. Total erythropoiesis decreased along with normalization of ineffective erythropoiesis and peripheral hemolysis. The reappearance of an erythropoietic activity measured over the sacrum was a constant finding, while in 1 patient, a depression of activity over the liver was observed. The new distribution and organization of erythropoiesis in the splenectomized patients is hypothesized as being due to the removal of the influence of an enlarged spleen on erythropoietic organs.