Smokers' dysmyelopoiesis--bone marrow alterations associated with cigarette smoking

Cigarette smoking is frequently associated with leukocytosis (with normal differential count) and polyglobulia in the peripheral blood. Corresponding studies on bone marrow alterations in smokers have not been done until now. We therefore investigated bone marrow trephine biopsies of 32 smoking persons. Biopsies had been mainly performed because of mild peripheral leukocytosis. In all cases we found a moderate increase in granulopoietic cells with a significant shift to the right and a distinct stimulation of phagocytic activity in macrophages. According to cytochemical findings, neutrophils are the major target of this phagocytic activity. We interpret these results as a smoking induced inhibition of locomotion in segmented neutrophils leading to an accumulation of mature polymorphs in the bone marrow with consecutive break-down and phagocytosis of senescent cells. We propose the designation "smokers' dysmyelopoiesis" for these changes.