Acute myelofibrosis terminating as acute myeloblastic leukemia

The case of an 8-year-old girl in whom acute myelofibrosis developed is described. The patient was managed conservatively. A year later evolution to acute myeloblastic leukemia occurred, accompanied by myeloid and erythroid dyspoiesis and an elevated fetal hemoglobin level. A remarkable reversal of the marrow fibrosis occurred when the patient was treated with combination chemotherapy. Intensive chemotherapy combined with extensive transfusion support, and possibly bone marrow transplantation, may offer similar patients hope for a prolonged survival and possible cure. The nature of acute myelofibrosis and its differential diagnosis are discussed.