Polycythaemia and Myelosclerosis

It is now fairly well recognized that myelosclerosis may present with polycythaemia (Stone and Woodman, 1938; Vaughan and Harrison, 1939; Marson and Meynell, 1949; Hutt, 1950). The problem of the relationship of this condition to polycythaemia rubra vera is still undecided. Rosenthal and Bassen (1938) believe that polycythaemia rubra vera can terminate with myelosclerosis. The question arises whether myelosclerosis follows as a natural sequence in the disease process or whether it is due to the effect of therapy. Wyatt and Sommers (1950), in a study of 30 cases, state that marrow sclerosis is more likely due " to the eventual attrition of the haemopoietic system by the chemical and physical agents employed to reduce the erythrocyte count." We reported two cases of polycythaemia with myelosclerosis which were treated with deep x-ray therapy (Marson and Meynell, 1949). The case recorded below has had acetylphenylhydrazine over a number of years. Deep x-ray therapy has never been used.