Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia

One case of acute panmyelosis with myelofibrosis (APMF) is being reported. A 45 year old male presented with abrupt onset of rapidly progressing low backache, weakness and pancytopenia. On examination there was no organomegaly. Peripheral blood examination revealed normocytic normochromic red blood...

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Main Authors: Tathagata Chatterjee, Srishti Gupta, Ajay Sharma, Sanjeevan Sharma, Devika Gupta
Format: Article
Language:English
Published: PAGEPress Publications 2013-06-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/index.php/mjhid/article/view/475
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author Tathagata Chatterjee
Srishti Gupta
Ajay Sharma
Sanjeevan Sharma
Devika Gupta
author_facet Tathagata Chatterjee
Srishti Gupta
Ajay Sharma
Sanjeevan Sharma
Devika Gupta
author_sort Tathagata Chatterjee
collection DOAJ
description One case of acute panmyelosis with myelofibrosis (APMF) is being reported. A 45 year old male presented with abrupt onset of rapidly progressing low backache, weakness and pancytopenia. On examination there was no organomegaly. Peripheral blood examination revealed normocytic normochromic red blood cells with 10% circulating blasts. Flowcytometric examination of peripheral blood revealed blasts which were positive for CD 34 ,HLA- DR and myeloid associated antigens (i.e. CD13 and CD33).Blasts were negative for anti MPO. Bone marrow aspirate resulted in a dry tap. Bone marrow biopsy revealed panmyeloid proliferation with scattered blasts which were CD 34 positive on imunohistochemistry and negative for anti MPO. Reticulin stain showed grade III myelofibrosis (WHO). Differential diagnosis considered included AML-M7, MDS-RAEB II and AML with myelodysplasia . He was started on chemotherapy [idarubicin and cytarabine; 3+7 induction regimen followed by three cycles of HIDAC (High dose cytosine arabinoside)] after which patient was in complete morphological remission with markedly reduced bone marrow fibrosis. He is now being worked up for allogeneic stem cell transplantation. Patient is asymptomatic at eight months of diagnosis. In conclusion these patients should be managed aggressively with AML therapy and this case report reaffirms the fact that APMF is subtype of AML.
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spelling doaj-art-05b51c0f4ba544c49e66ab5409b2ca812025-08-20T02:58:04ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062013-06-0151e2013042e201304210.4084/mjhid.2013.042367Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid LeukemiaTathagata ChatterjeeSrishti GuptaAjay SharmaSanjeevan SharmaDevika GuptaOne case of acute panmyelosis with myelofibrosis (APMF) is being reported. A 45 year old male presented with abrupt onset of rapidly progressing low backache, weakness and pancytopenia. On examination there was no organomegaly. Peripheral blood examination revealed normocytic normochromic red blood cells with 10% circulating blasts. Flowcytometric examination of peripheral blood revealed blasts which were positive for CD 34 ,HLA- DR and myeloid associated antigens (i.e. CD13 and CD33).Blasts were negative for anti MPO. Bone marrow aspirate resulted in a dry tap. Bone marrow biopsy revealed panmyeloid proliferation with scattered blasts which were CD 34 positive on imunohistochemistry and negative for anti MPO. Reticulin stain showed grade III myelofibrosis (WHO). Differential diagnosis considered included AML-M7, MDS-RAEB II and AML with myelodysplasia . He was started on chemotherapy [idarubicin and cytarabine; 3+7 induction regimen followed by three cycles of HIDAC (High dose cytosine arabinoside)] after which patient was in complete morphological remission with markedly reduced bone marrow fibrosis. He is now being worked up for allogeneic stem cell transplantation. Patient is asymptomatic at eight months of diagnosis. In conclusion these patients should be managed aggressively with AML therapy and this case report reaffirms the fact that APMF is subtype of AML.http://www.mjhid.org/index.php/mjhid/article/view/475leukemia
spellingShingle Tathagata Chatterjee
Srishti Gupta
Ajay Sharma
Sanjeevan Sharma
Devika Gupta
Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia
Mediterranean Journal of Hematology and Infectious Diseases
leukemia
title Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia
title_full Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia
title_fullStr Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia
title_full_unstemmed Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia
title_short Acute Panmyelosis with Myelofibrosis - A Rare Subtype of Acute Myeloid Leukemia
title_sort acute panmyelosis with myelofibrosis a rare subtype of acute myeloid leukemia
topic leukemia
url http://www.mjhid.org/index.php/mjhid/article/view/475
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AT srishtigupta acutepanmyelosiswithmyelofibrosisararesubtypeofacutemyeloidleukemia
AT ajaysharma acutepanmyelosiswithmyelofibrosisararesubtypeofacutemyeloidleukemia
AT sanjeevansharma acutepanmyelosiswithmyelofibrosisararesubtypeofacutemyeloidleukemia
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