Haemocytic periodicity and periodic disorders: periodic neutropenia, thrombocytopenia, lymphocytosis and anaemia.

Evidence has accumulated of rhythmic numerical oscillation of each of the blood cells either independently or in combinations. The cyclic changes originate in the marrow of some normal persons and animals without causing illness, and can be induced experimentally. In more than 100 reported instances, periodic oscillations of various cells were accompanied by respective episodes of the disorders named in the title. The disorders may be transitory but usually recur throughout life and occasionally are fatal. All resist therapy. Features in common suggest an interrelationship of the haemal disorders and other disparate heritable periodic diseases. Theoretically, the rhythms are regulated by ubiquitous, inherent, intracellular bioclocks controlled hypothalamically or neurohumorally in relation to a feedback mechanism. Reactions to long cycles are of greater clinical importance than disturbances arising from the circadian rhythm.