DOI: 10.36347/sjmcr.2015.v03i11.021

Pages: 1079-1081

MPNs are acquired clonal disorders of the hematopoietic stem cells characterized by the hyperplasia of one or several myeloid lineages. The aim of this study is evaluation of treatment a patient with AML after primary MF during her treatment. A 46-year-old female patient was presented to us 4 years ago with a one-month history of fatigue, night sweats, and abdominal distention. The biopsy results were reported as myelofibrosis. In the past history the assays for JAK2 V617F was positive and the Philadelphia chromosome was negative. We investigated the secondary myelofibrosis events, but all of them were negative. Treatment of myelofibrosis-related anemia was started with androgen (danazol). Afterwards, treatment with thalidomide (100 mg/day) was started. The patient was followed under thalidomide treatment for about 6 months. Thalidomide treatment was stopped and then we applied for compassionate use of ruxolitinib and splenic irradiation. At the beginning of ruxolitinib treatment, the constitutional symptoms regressed, but at the end of the sixth month her disease transformed to acute myeloblastic leukemia (AML). She was treated with low dose cytarabine 20 mg/day subcutaneous combined with ruxolitinib for two months with transfusion support. The patient died 3 months after recent rehospitalization, because of invasive aspergillosis. PMF is a serious bone marrow disorder and asymptomatic and its treatment is difficult. We can use other treatment methods like immunomodulating drugs, oncogenic pathways and target epigenetic and HSCT.