Acute myelofibrosis terminating in an acute lymphoblastic leukemia. A case report

✍ Scribed by Hassan Amjad; Sefer Gezer; Susumu Inoue; Robert O. Bollinger; Joseph Kaplan; S. Carson; Carter R. Bishop

• Publisher: John Wiley and Sons
• Year: 1980
• Tongue: English
• Weight: 1014 KB
• Volume: 46
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19800801)46:3<615::aid-cncr2820460331>3.0.co;2-x

✦ Synopsis

A patient with acute myelofibrosis developed acute leukemia during the course of her disease. Light microscopic examination showed that the cells were lymphoblasts. The presence of terminal deoxynucleotidyl transferase and Tand B-lymphocyte markers suggested that the malignancy was of immature lymphoid cell origin. Terminal leukemic transformation in some cases of acute myelofibrosis may be of a lymphoid nature and, thus, less toxic chemotherapy could be used with a better prognosis.

Cancer 46:615-618, 1980.

CUTE MYELOFIBROSIS, a variant of the myelopro-

A liferative syndrome, is characterized by rapid onset of pancytopenia, normal red blood cell morphology, extensive myelofibrosis, and an absence of hepa-t~splenomegaly.'~ Myeloblastic leukemia is described as a terminal event but lymphoblastic leukemia is not mentioned.

Herein, we report a case of a 5 1-year-old woman who underwent a rapid clinical course of pancytopenia, which evolved into an acute leukemic phase.

Case Report

A 51-year-old woman was admitted to Grace Hospital in November 1975 with history of dyspnea and fever. She had become progressively fatigued over the several weeks prior to admission. She had no history of night sweats, weight loss, or hemoptysis. The clinical examination was essentially negative except for the pallor of her conjunctiva. No hepatosplenomegaly or lymphadenopathy was noted. Results of laboratory studies included: hemoglobin, 7.8 g/dl; PCV, 24 mUdl; MCV, 95 fl; MCH, 29.9pg; MCHC, 31 g/dl; leukocytes, 6.4 x 1Oy/liter, with a differential count of PMN, 47%; band,