[Allogeneic bone marrow transplantation as primary treatment in acute myelofibrosis]

A 20-year-old man with acute myelofibrosis received ablative chemotherapy consisting of busulfan, Ara-C and cyclophosphamide followed by bone marrow transplantation from his histocompatible sister. There was a prompt engraftment with a rising WBC and platelet count and with donor karyotype in specimen of marrow. A bone marrow examination on day 29 showed a prominent decrease in marrow fibrosis. However, fibrosis was again exacerbated with leukemic relapse as overt acute megakaryoblastic leukemia on day 110, The patient died on day 126. Marrow fibrosis was found to be reversible by ablation of malignant cells and repopulation of normal hemopoietic cells after bone marrow transplantation.