Hematology And Oncology Chapter 130. There is increased production and turnover of RBCs, neutrophils, and platelets. Increased megakaryocytes may be present in clumps. The cause of this proliferation is unknown. Extramedullary hemopoiesis occurs in the spleen, liver, and other sites with the potential for blood cell formation.
Some patients are asymptomatic and are first identified on routine blood examination.
A bleeding diathesis is common. Pruritus often occurs, particularly after a hot bath. The face may be red and the retinal veins engorged. Patients may present with peptic ulcer disease, thrombosis, Budd-Chiari syndrome, or bone pain. Eventually, erythroid activity in the marrow decreases.