Modulation of megakaryocyte emperipolesis by phlebotomy: megakaryocytes as a component of marrow-blood barrier.

The presence of marrow cells within the cytoplasm of megakaryocytes has been documented and is attributed to the phenomenon of emperipolesis. In a previous study most patients demonstrating this phenomenon had or were suspected of having blood loss. To find out if these are causally related, we induced acute and chronic blood loss in rats and quantitatively measured the emperipolesis index (EI). EI dropped after acute blood loss but rose after chronic blood letting, indicating that blood loss can modulate this phenomenon. In the marrow, megakaryocytes are located preferentially on the abluminal side of sinus endothelium and it is postulated that in the state of heightened demand for cell delivery from marrow into the circulation, some cells take a transmegakaryocytic route to enter the circulation. This concept incorporates megakaryocytes as a component of the marrow-blood barrier.