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A 62-year-old white man with a past medical history of hypertension and essential thrombocytosis diagnosed 17 years ago presented at our institution. He was being treated with hydroxyurea, with which he required occasional blood transfusions and platelets were controlled around 400 x 109/L range. Over a 2-month period, he developed gradually worsening exertional dyspnea, fatigue, decreased appetite, lost about 8 lb in weight. He was found to be pancytopenic, with a total white cell count of 3.26 x 109/L (normal, 3.8-10.6 x 109/L), his hemoglobin level was 7.9 gm/dL (normal, 12.9-16.9 gm/dL), and his platelet count, 46 x 109/L. A bone marrow aspirate and biopsy revealed 100% cellularity, approximately 8%-10% CD34 positive blasts, and numerous atypical and hypolobated dysplastic megakaryocytes with increased reticulin fibrosis. He was diagnosed with myelofibrosis with underlying myeloproliferative disorder, which seemed to be progressing into a more accelerated phase. He was admitted for induction chemotherapy with cytarabine and idarubicin as a bridge to a matched allogeneic stem cell transplant.
*Click on the link to the left for a PDF of the full article.
A 62-year-old white man with a past medical history of hypertension and essential thrombocytosis diagnosed 17 years ago presented at our institution. He was being treated with hydroxyurea, with which he required occasional blood transfusions and platelets were controlled around 400 x 109/L range. Over a 2-month period, he developed gradually worsening exertional dyspnea, fatigue, decreased appetite, lost about 8 lb in weight. He was found to be pancytopenic, with a total white cell count of 3.26 x 109/L (normal, 3.8-10.6 x 109/L), his hemoglobin level was 7.9 gm/dL (normal, 12.9-16.9 gm/dL), and his platelet count, 46 x 109/L. A bone marrow aspirate and biopsy revealed 100% cellularity, approximately 8%-10% CD34 positive blasts, and numerous atypical and hypolobated dysplastic megakaryocytes with increased reticulin fibrosis. He was diagnosed with myelofibrosis with underlying myeloproliferative disorder, which seemed to be progressing into a more accelerated phase. He was admitted for induction chemotherapy with cytarabine and idarubicin as a bridge to a matched allogeneic stem cell transplant.
*Click on the link to the left for a PDF of the full article.
A 62-year-old white man with a past medical history of hypertension and essential thrombocytosis diagnosed 17 years ago presented at our institution. He was being treated with hydroxyurea, with which he required occasional blood transfusions and platelets were controlled around 400 x 109/L range. Over a 2-month period, he developed gradually worsening exertional dyspnea, fatigue, decreased appetite, lost about 8 lb in weight. He was found to be pancytopenic, with a total white cell count of 3.26 x 109/L (normal, 3.8-10.6 x 109/L), his hemoglobin level was 7.9 gm/dL (normal, 12.9-16.9 gm/dL), and his platelet count, 46 x 109/L. A bone marrow aspirate and biopsy revealed 100% cellularity, approximately 8%-10% CD34 positive blasts, and numerous atypical and hypolobated dysplastic megakaryocytes with increased reticulin fibrosis. He was diagnosed with myelofibrosis with underlying myeloproliferative disorder, which seemed to be progressing into a more accelerated phase. He was admitted for induction chemotherapy with cytarabine and idarubicin as a bridge to a matched allogeneic stem cell transplant.
*Click on the link to the left for a PDF of the full article.