SUMMARY Peripheral blood lymphocyte subpopulations were measured in 18 patients with primary proliferative polycythaemia and 13 patients with secondary polycythaemia. A decrease in numbers of suppressor T lymphocytes and an increase in the helper:suppressor T lymphocyte ratio was found in those with primary polycythaemia compared with normal subjects and patients with secondary polycythaemia. If other causes of an increased helper:suppressor ratio are excluded this variable may be useful in confirming the myeloproliferative nature of patients with erythrocytosis.In 1983 Eridani et al reported a study of peripheral blood lymphocyte subpopulations in patients with primary proliferative polycythaemia and idiopathic erythrocytosis.' They found that in both groups there was a decrease in total numbers of Tlymphocytes, with a particular decrease in the suppressor lymphocytes compared with the numbers seen in normal controls, so that the helper:suppressor Tlymphocyte ratio was increased.We performed a study of peripheral blood lymphocyte subpopulations in patients with primary proliferative and secondary polycythaemia to determine whether the helper:suppressor T lymphocyte ratio differed between the two groups. Material and methods SELECTION OF PATIENTSNew and follow up patients with primary proliferative and secondary polycythaemia attending the outpatient departments at the Northern General and Royal Hallamshire Hospitals, Sheffield were studied.Primary proliferative polycythaemia Primary proliferative polycythaemia was diagnosed in patients fulfilling the following criteria: raised haematocrit and increased red cell volume, as measured by the 5tCr dilution technique giving values greater than 25% of the expected value adjusted for height and weight2; together with the presence of at least two of the following variables, splenomegaly, increased Accepted for publication 21 August 1986 neutrophil and platelet counts, and an increased leucocyte alkaline phosphatase value. These criteria differ slightly from those laid down by the Polycythaemia Vera Study Group.3 Our group contained 18 patients, 10 men and eight women, with a mean age of 63 years (range 31-89).Twelve of them had been diagnosed within the previous five years, and the remaining six had been diagnosed at varying times prior to this. Seven had well documented splenomegaly at some time during their disease; eight had received at least one injection of 32P; and another three had required intermittent courses of busulphan to control their disease over the time before the study started. A further three patients had been controlled by venesection only. The remaining three were included in the study at the time of diagnosis.
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