[Primary myelofibrosis successfully treated with allogeneic bone marrow transplantation]

Area of Science:

• Hematology
• Oncology
• Stem Cell Transplantation

Background:

• Primary myelofibrosis is a serious bone marrow disorder characterized by fibrosis and abnormal blood cell production.
• Current therapies for primary myelofibrosis are limited, often focusing on symptom management rather than cure.

Observation:

• A patient with primary myelofibrosis initially treated with low-dose Ara-C experienced only partial improvement in splenomegaly, with persistent pancytopenia.
• Following allogeneic bone marrow transplantation without irradiation or splenectomy, the patient developed hypoplastic bone marrow, necessitating G-CSF support.
• Post-transplantation peripheral blood analysis revealed the disappearance of leukoerythroblastosis and tear-drop poikilocytosis.

Findings:

• Allogeneic bone marrow transplantation led to the complete resolution of bone marrow fibrosis.
• Hematopoiesis normalized within 17 months post-transplantation, indicating successful engraftment and recovery.
• Granulocyte-colony stimulating factor (G-CSF) was beneficial in managing systemic infection post-transplant.

Implications:

• Allogeneic bone marrow transplantation represents a potentially curative therapy for primary myelofibrosis.
• This case highlights the efficacy of a non-myeloablative conditioning regimen in achieving successful outcomes.
• Further research into bone marrow transplantation as a primary treatment for myelofibrosis is warranted.