Incidence of Rarity
Primary Myelofibrosis converted into AML - M7
A 62 year old man experiencing nasal bleeding and weakness visited
Nanavati Super Speciality Hospital. His investigations revealed
anaemia with leucocytosis and thrombocytosis. His was a known case
of primary Myelofibrosis, a disorder in which normal bone marrow
tissue is gradually replaced with fibrous tissue. He was prescribed oral
Danazole tablet for his condition but in spite of its regular consumption
he developed recurrent epistaxis. He had also undergone Splenectomy
a year back at a local hospital.
On further investigations his bone marrow aspiration showed 80%
blasts. Immunophenotyping revealed positivity for platelet precursor
markers ( CD41,CD61). These blasts were negative for other myeloid
and lymphoid markers. His diagnosis was positive for Acute Myeloid
Leukaemia with megakaryocytic differentiation (FAB AML M7).
A fraction of patients with Myelofibrosis progress to Acute Myeloid
Leukaemia. But Medical and Haemato-Oncologists from Nanavati
Hospital diagnosed this rare condition. Considering high risk factors
present in this patient and taking into account his age and poor
performance status, he was deemed unfit for Allogeneic Stem Cell
Transplantation. Thus, Decitabine was started accordingly.
Myelofibrosis converting into AML is a very rare phenomenon but our
expert Medical and Haemato-Oncologists diagnosed this rare condition.
The identification of high risk factors of transformation to AML will
allow for early therapeutic intervention and treatment.