A patient's laboratory results indicate a markedly increased hemoglobin, hematocrit, and red blood cell count. White blood cells and platelets are also slightly increased. The erythropoietin level is decreased. Which is most likely:

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The combination of markedly increased hemoglobin, hematocrit, and red blood cell count, along with slightly increased white blood cells and platelets and a decreased erythropoietin level, is consistent with the diagnosis of polycythemia vera. Relative polycythemia is characterized by an apparent increase in red blood cell count due to a decrease in plasma volume, whereas secondary polycythemia is due to an increase in erythropoietin production in response to hypoxia, such as in chronic lung disease or high-altitude living. Reactive erythrocytosis is an increase in red blood cell count due to a reactive process, such as chronic inflammation or a tumor.

A Patient's Laboratory Results Indicate a Markedly Increased Hemoglobin, Hematocrit