The authors of this study established a range of Platelet Parameters, the mean platelet volume (MPV), and the platelet distribution width (PDW), a measure of platelet anisocytosis, in patients with very high platelet counts-that is, those with hyperthrombocytosis (platelet counts 800X10(3)/cu mm [800X10(9)/L] or greater). The authors reviewed the demographic data, associated disorders (with the exception of iron deficiency and renal failure), and platelet parameters of 367 consecutive patients with hyperthrombocytosis. These patients' associated conditions approximated those of patients with less severe thrombocytosis.1 The authors suggest that the combined use of all of the platelet parameters might improve discriminations between reactive thrombocytosis and essential thrombocythemia.