Oxygen Saturation of Sternal Marrow Blood with Special Reference to Pathogenesis of Polycythemia Vera. ∗

Abstract

Summary

An attempt was made to measure the stimulus to erythropoiesis in the human bone marrow by estimating the percentage oxygen saturation of blood removed from the sternal marrow cavity through a needle inserted through the cortex as in the performance of a sternal needle biopsy. By this means, blood samples were collected without effective contact with air and their oxygen content, capacity and in some instances pH were determined. In general no significant differences were demonstrated between normals, convalescent controls, anemic patients, and patients with polycythemia vera. In patients with secondary polycythemia, the percentage oxygen saturation of the blood removed from the bone marrow was relatively reduced, probably entirely as a result of the manifest unsaturation of the arterial blood. In some patients with leukemia and with myeloid metaplasia and in some patients with polycythemia vera with evidence of excessive myeloid activity, the data suggest an increased local oxygen utilization relative to the blood flow in the bone marrow. However, it was concluded that the technics used were not adequate to demonstrate an anoxic stimulus to increased erythropoiesis even in the marrow of patients with chronic anemia, possibly because of the difficulty of obtaining blood samples satisfactorily representative of the undisturbed environment of the erythropoietic cells.