'Classic' and 'acute' myelofibrosis. A retrospective study

In a retrospective study of 38 patients with histologically proven myelofibrosis, 5 parameters (recorded on the first admission) were investigated as to their usefulness to predict the course of the disease. In 9 patients the development of 'acute' myelofibrosis could be predicted by the finding of pancytopenia, low reticulocyte counts (median 20,500/mul), extremely elevated SRE (median 125 mm) and normal serum levels of LDH and uric acid on the first admission. In 28 patients the development of classic fibrosis with splenomegaly could be predicted by the finding of high reticulocyte counts (median 133,200/mul) and increased levels of serum LDH (median 547 U) and uric acid (median 8 mg/dl in males and 6.8 mg/dl in females) on the first admission, even when splenomegaly was initially absent. The relationship between classic and acute myelofibrosis and the significance of the mentioned parameters is discussed.