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Research Article Free access | 10.1172/JCI106077

Thrombokinetics in man

Laurence A. Harker and Clement A. Finch

1Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105

Find articles by Harker, L. in: JCI | PubMed | Google Scholar

1Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105

Find articles by Finch, C. in: JCI | PubMed | Google Scholar

Published June 1, 1969 - More info

Published in Volume 48, Issue 6 on June 1, 1969
J Clin Invest. 1969;48(6):963–974. https://doi.org/10.1172/JCI106077.
© 1969 The American Society for Clinical Investigation
Published June 1, 1969 - Version history
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Abstract

Platelet production, distribution, and destruction have been quantitated in normal man and in selected patients with platelet disorders. In most instances, total production as calculated from the megakaryocyte mass agreed with production estimated from platelet turnover. In patients with megaloblastosis, a discrepancy between these two measurements indicated the presence of ineffective thrombopoiesis.

Thrombopoiesis was regulated by (a) alterations in megakaryocyte number, and (b) changes in megakaryocyte volume (produced by changes in endomitosis). The volume-endomitosis changes were closely related to the peripheral platelet count and were a useful indicator of thrombopoietic stimulus.

Thrombocytopenic disorders have been classified on the basis of the disturbed physiology into disorders of (a) production (hypoproliferative or ineffective), (b) distribution (splenic pooling), or (c) destruction (immune or consumptive). Less than a twofold increase in platelet production in the presence of significant thrombocytopenia was taken to represent impaired proliferation.

Thrombocytosis was classified as reactive or autonomous. Reactive thrombocytosis was consistently associated with a mean megakaryocyte volume and endomitosis less than normal but appropriate for the elevated circulating platelet count. In contrast, the average megakaryocyte volume and nuclear number were always greater than normal in thrombocythemia findings indicating autonomy.

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