A case of somewhat atypical polycythemia vera with marked leukocytosis and terminal myeloblastic leukemia has been studied hematologically and biochemically. The biochemical studies consisted of repeated estimations of the leukocytic alkaline and acid phosphatase activities during the last nine months of the patient’s life. These studies suggested that, except during the terminal myeloblastic leukemia, there was a leukemoid reaction rather than chronic myelogenous leukemia associated with polycythemia. The significance of these findings is briefly discussed and it is suggested that the widespread application of similar biochemical studies to cases of polycythemia vera with marked leukocytosis might be of value its helping to determine the true incidence of myelogenous leukemia in this disease.

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