Differential diagnosis of myelofibrosis based on WHO 2008 criteria: Acute panmyelosis with myelofibrosis, acute megakaryoblastic leukemia with myelofibrosis, primary myelofibrosis and myelodysplastic syndrome with myelofibrosis. Issue 6 (22nd May 2013)

• Record Type: Journal Article
• Authors: Bae, E.; Park, C.‐J.; Cho, Y.‐U.; Seo, E.‐J.; Chi, H.‐S.; Jang, S.; Lee, K.‐H.; Lee, J.‐H.; Lee, J.‐H.; Suh, J.‐J.; IM, H.‐J.
• Is Part Of: International journal of laboratory hematology. Volume 35:Issue 6(2013:Dec.)
• Page Start: 629
• Page End: 636
• Publication Date: 2013-05-22
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Hematology -- Periodicals; 616.15005
• DOI: 10.1111/ijlh.12101
• Languages: English
• ISSNs: 1751-5521

Abstract

<abstract abstract-type="main" id="ijlh12101-abs-0001"> <title>Summary</title> <sec id="ijlh12101-sec-0001" sec-type="section"> <title>Introduction</title> <p>The aim of this study was to characterize clinicopathological features of acute panmyelosis with myelofibrosis (APMF), acute megakaryoblastic leukemia with myelofibrosis (AMKL‐MF), primary myelofibrosis (PMF) and myelodysplastic syndrome with myelofibrosis (MDS‐MF) in order to provide the keys to the differential diagnosis of bone marrow (BM) fibrosis.</p> </sec> <sec id="ijlh12101-sec-0002" sec-type="section"> <title>Methods</title> <p>We compared age, gender, splenomegaly, serum lactate dehydrogenase level, blood cell counts, blast counts in peripheral blood (PB) and BM, megakaryocyte counts, BM cellularity, dysplasia, and the karyotypes of patients with APMF (<italic>n</italic> = 6), AMKL‐MF (<italic>n</italic> = 7), PMF (<italic>n</italic> = 44), and MDS‐MF (<italic>n</italic> = 44).</p> </sec> <sec id="ijlh12101-sec-0003" sec-type="section"> <title>Results</title> <p>APMF showed hyperplasia of all three lineages, increase in megakaryocyte count with dysplasia and frequent abnormal karyotypes. AMKL‐MF was associated with elevated BM blast counts, decreased BM megakaryocyte count with rare megakaryocytic dysplasia and chromosome 21 abnormality. PMF patients displayed splenomegaly, rare blasts in PB/BM, and <italic>JAK2 V617F</italic> mutation. MDS‐MF patients showed pancytopenia, dysplasia in all three lineages and recurrent chromosomal abnormalities involving chromosome 5, 7, 12, and 17.</p> </sec> <sec id="ijlh12101-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Although differential diagnosis among APMF, AMKL‐MF, PMF, and MDS‐MF is very challenging due to the overlapping clinical and morphological features, meticulous investigation of the patient with respect to splenomegaly, blood cell count, PB and BM findings, and karyotype will serve as a guide to correct diagnosis.</p> </sec> </abstract>