The alkaline and acid phosphatase content of blood and bone marrow has been studied by the methods of Gomori-Takamatsu and Gomori in normal individuals and in a great number of different diseases. The presence of a particular phosphatase is related to cellular reaction. Alkaline phosphatase was found in orthochromic normoblasts, polymorphonuclear leukocytes, metamyelocytes and older megakaryocytes. Acid phosphatase was demonstrated in basophilic normoblasts, polymorphonuclear leukocytes and their juvenile forms and in young megakaryocytes. In red blood cells and young megakaryocytes phosphatase was present chiefly in the nuclei, in leukocytes and older megakaryocytes in the cytoplasm.

By studying erythropoiesis, especially during active regeneration of blood, it has been shown that alkaline phosphatase plays a decisive part in the disappearance of the normoblast nucleus. In certain diseases abnormality is observed in the disappearance of the normoblast nucleus (effort syndrome, rheumatoid arthritis). In others acid phosphatase occurs in large amounts in the youngest normoblasts (polycythemia vera, rheumatoid arthritis, nephritis). At the same time phosphatase may also be found in polymorphonuclear leukocytes and their juvenile forms. In rare cases of severe anemia alkaline phosphatase (panmyelophthisis) or acid phosphatase (achrestic anemia) is noted in large amounts in nucleated red cells and in leukocytes.

Only alkaline phosphatase is present in polymorphonuclear leukocytes and metamyelocytes in leukemias, myeloma, Hodgkin’s and Paget’s disease, and in some malignant tumors of the skeleton and the liver.

Several circumstances indicate that phosphatases might destroy cells or their nuclei. In some cases phosphatase activity is physiologic, in others phosphatase concentration is related to accelerated or malignant growth of bone marrow or tissue associated with blood formation. Finally there are cases in which there is as yet no explanation for the appearance of phosphatases.

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