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© 2006 by the American Society of Hematology

Print ISSN: 1520-4391; Online ISSN 1520-4383.

Hematology, the American Society of Hematology Education Program Book, is published annually by the American Society of Hematology (ASH) in one volume per year. 

All business correspondence and purchase and reprint requests should be addressed to the American Society of Hematology, 1900 M Street NW, Suite 200, Washington, DC 20036. Telephone: 202-776-0544. Fax: 202-776-0545. E-mail: ASH@hematology.org.

Hematology 2006 is available on the Internet at http://www.asheducationbook.org.

© 2006 by The American Society of Hematology. All rights reserved. Copyright is not claimed in any works of the United States Government. Except as expressly permitted in this statement, no part of this publication may be used (as hereinafter defined) in any form or by any means now or hereafter known, electronic or mechanical, without permission in writing from the Publisher, The American Society of Hematology. For purposes of this notice, the term "use" includes but is not limited to reproduction, photocopying, storage in a retrieval system, translation, and transmittal. The Publisher hereby consents to the use of this publication or any part hereof for any non-commercial educational purpose within the health field such as classroom instruction, and clinical and residency training. This publication or any part thereof may be used for educational purposes at conferences, continuing education courses, and other educational activity, provided no fee or other compensation is charged therefore. All materials so used must acknowledge the Publisher’s copyright therein as "@2006 by The American Society of Hematology." When requesting the Publisher’s permission to use this publication or any part thereof, please contact the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923, USA (978) 750-8400; fax (978) 750-4470 or The American Society of Hematology Publications Office at 1900 M Street, N.W., Suite 200, Washington, D.C. 20036, USA (202) 776-0544; fax (202) 776-0545.

Cite articles in this volume by listing Author(s), Title, Hematology (Am Soc Hematol Educ Program). 2006; beginning page number-ending page number.

The publisher disclaims responsibility for opinions expressed by the authors.

Committee on Educational Affairs

Michael Williams, MD(2004-2007) (Chair)
Swati Basu, MBBS (2004-2007)
Kristie A. Blum, MD (2005-2008)
Joseph Connors, MD (2004-2007)
John F. DiPersio, MD, PhD (2004-2006)
Bertil Glader, MD, PhD (2004-2007)
Stephanie Lee, MD, MPH (2006-2009)
Eduardo M. Sotomayor, MD (2005-2008)
F. Marc Stewart, MD (2004-2007)
Daniel Weisdorf, MD (2003-2006)
Jeffrey Weitz, MD (1999-2006)
Jane N. Winter, MD (2006-2009)

Ex Officio:
Kanti R. Rai, MD (President)
Andrew I. Schafer, MD (President-Elect)
Kenneth Kaushansky, MD (Vice President)
Armand Keating, MD (Secretary)
Nancy Berliner, MD (Education Program Book Editor)
Charles Linker, MD (2006 Education Program Co-Chair)
Charles A. Schiffer, MD (2006 Education Program Co-Chair)
John Lazarchick, MD (2006 Co-Editor-in-Chief, Image Bank)
Peter Maslak, MD (2006 Co-Editor-in-Chief, Image Bank)
Shirley Parker Levine, MD (Chair, Teaching Cases Taskforce)

Cover: Drs. Ross Levine and Gerlinde Wernig. Figure 1. Model of the molecular pathogenesis of polycythemia vera (PV), essential thrombocytosis (ET), and myelofibrosis (MF). Illustration by Eric Smith.

The American Society of Hematology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The American Society of Hematology designates this educational activity for a maximum of 37.25 AMA PRA Category1 Credits™. Physicians should claim only credits commensurate with the extent of their participation in the activity. Physicians not licensed in the United States who participate in this CME activity are also eligible for AMA Physician Recognition Award (PRA) category 1 credit.

The printing of Hematology 2006 was made possible by an educational grant from AMGEN Oncology.

Editors of Hematology 2006:

Nancy Berliner, MD
Executive Editor, Hematology 2006
Professor, Internal Medicine and Genetics
Yale University School of Medicine
New Haven, CT