1950/03/18 by WILLIAM DAMESHEK, William Dameshek · 1 citation
Medicine · #Myeloproliferative Neoplasms: Diagnosis and Treatment #Hematological disorders and diagnostics #Hemoglobinopathies and Related Disorders
paper · doi:10.1001/jama.1950.02910290018005
<h3>I. INTRODUCTION AND POSSIBLE ETIOLOGIC FACTORS</h3> 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 B<sub>12</sub>), certain other constituents of the vitamin B complex, including folic acid, certain amino acids and