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The ‘spent’phase of polycythaemia vera: hypersplenism in the absence of myelofibrosis

Summary A clinical phase (spent phase) in the course of polycythaemia vera (PV) cases is described as enlargement of the spleen in spite of treatment, frequent cytopenia of one or several lines, persistent red cell hypervolaemia with considerable increase of plasma volume, persistence of myeloid hyperplasia with no collagen myelofibrosis or osteomyelosclerosis, absence of hepatosplenic erythro‐blastic metaplasia, as shown by radio‐iron kinetics and/or 111In‐transferrin scintigraphy.