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Secondary Myelofibrosis
Myelofibrosis Secondary

Presentation

The authors present the case of an infant with severe rickets and secondary myelofibrosis and review the differential diagnosis of hepatosplenomegaly from the viewpoint of the pediatric hematologist/oncologist. [ncbi.nlm.nih.gov]

Case presentation We report a 36-year-old pregnant woman who presented with cytopenia, fatigue, vomiting, and diarrhea for 20 days on the background of newly diagnosed myelofibrosis secondary to gastric signet ring adenocarcinoma. [bmccancer.biomedcentral.com]

Entire Body System

  • Gaucher Disease

    […] various pathological processes that involve the bone marrow Causes of secondary myelofibrosis: Neoplastic – infiltration by cancer cells (primary is usually located in breast, lung or prostate) Infective – tuberculosis, fungal infections, HIV Metabolic – Gaucher [pgblazer.com]

Neurologic

  • Encephalopathy

    These benefits were accompanied by toxic effects in some patients, the most important being encephalopathy of unknown mechanism. Clinical development of fedratinib was subsequently discontinued. [ncbi.nlm.nih.gov]

    Cardiovascular Outcomes Data Managing Epilepsy: Parting Advice for Neurologists Type 2 Diabetes and Cardiovascular Disease: Risk Factors Managing Asthma With Biologic Therapy Selecting and Using a GLP-1 Agonist to Treat T2D Potential of Cannabidiol in Epileptic Encephalopathies [raredr.com]

    Complications Portal hypertension may result in variceal bleeding, ascites and hepatic encephalopathy. Hepatic or portal vein thrombosis may also occur. Splenic infarction: usually self-limited and treated with fluids and opiate analgesics. [patient.info]

    For example, XL019 was halted in a Phase I trial owing to peripheral neuropathy despite dose reductions. 50 Phase III trials of fedratinib (SAR302503) found significant neurotoxicity, specifically Wernicke’s encephalopathy, 51 while studies with lestaurtinib [dovepress.com]

  • Irritability

    Radiotherapy can cause temporary side effects, such as tiredness and skin irritation, although generally these are mild. Stem cell transplant (from a donor) Rarely, a stem cell transplant is used to treat people with myelofibrosis. [macmillan.org.uk]

    Long-term mental stress, anxiety, irritability, pessimism and other emotions, will make the cerebral cortex excitement and inhibition of the process of imbalance, so need to maintain a happy mood. life restraint attention to rest, work and rest, orderly [healthfrom.com]

Workup

(See Presentation, Workup, and Treatment .) Splenic infarction may occur and results in an acute or subacute onset of severe pain in the left upper quadrant that may be associated with nausea, fever, and referred left shoulder discomfort. [emedicine.medscape.com]

Hyperuricemia is due to enhanced turnover of hematopoietic tissue. 26 Mutation testing Testing for the JAK2 V617F mutation should be performed early during the diagnostic workup of suspected MPNs. [mpncanada.com]

Of patients with Budd-Chiari syndrome (hepatic-inferior vena cava obstruction), 10% to 13% have coexisting PV; therefore, testing for the presence of JAK2 V617F mutation is part of the routine workup for unexplained liver thrombosis. [clevelandclinicmeded.com]

Serum

  • Decreased Platelet Count

    The study by Tefferi et al. [14] also showed some similarities with our study; they found older age group, normal to high platelet count and blast percentage et al. [15] was also in line with our observations. [ijpmonline.org]

    Decreasing platelet counts in ET to below 600 x 10 9 /L can decrease thrombotic complications. 46 High platelet counts (>1,000 x 10 9 /L) are associated with acquired von Willebrand disease resulting from the adsorption of von Willebrand multimers onto [clevelandclinicmeded.com]

  • Hyperviscosity

    Thrombocythaemia persists even after correction of hyperviscosity by phlebotomy [ 23, 36 ]. [err.ersjournals.com]

    Elevated white blood cell (WBC) counts have been found in 50% of patients. 14 Elevated hematocrit has been associated with symptoms of hyperviscosity including headache, blurred vision, and plethora. [clevelandclinicmeded.com]

  • Neutrophilia

    The peripheral blood smear showed marked neutrophilia with mild bandemia, the erythroid lineage was notable for rare nucleated red blood cells and occasional teardrop cells. [hsrc.himmelfarb.gwu.edu]

Biopsy

  • Dry Tap Bone Marrow

    She was subjected to bone marrow examination. Bone marrow aspiration revealed a dry tap. [ijcasereportsandimages.com]

Treatment

RESULTS: The patients showed excellent response to treatment one month post-radiotherapy, while treatment was well tolerated without severe toxicity. The dimensions of the spleen decreased significantly. [ncbi.nlm.nih.gov]

Treatment Treatment of secondary myelofibrosis treatment Department of Internal Medicine: Department of Hematology Treatment: drug treatment support treatment of surgical treatment Treatment cycle: 1-3 months Cure rate: 80% (A) treatment The disease can [healthfrom.com]

Prognosis

What is the Prognosis for MF? There is no single prognosis for people who suffer from myelofibrosis– the prognosis of MF is different for every patient. [mpnresearchfoundation.org]

Determine DIPSS risk category and prognosis DIPSS score DIPSS risk category Median OS (y) 0 Low Not reached 1 - 2 Intermediate-1 14.2 3 - 4 Intermediate-2 4 5 - 6 High 1.5 IWG-MRT prognostic score for myelofibrosis Applies at the time of diagnosis. 1. [bloodref.com]

Also, these cases may represent a clonal disorder with genetic instability allowing evolution to a more aggressive malignancy. [13] The prognosis in our patient could not be judged following ATT since the child was lost to follow up. [ijcasereportsandimages.com]

Prognosis is poor, with slow progression and death usually within 2-3 years. [radiopaedia.org]

AB - Primary myelofibrosis (PMF) is a Philadelphia chromosome negative myeloproliferative neoplasm (MPN) with adverse prognosis and is associated with bone marrow fibrosis and extramedullary hematopoiesis. [einstein.pure.elsevier.com]

Etiology

MVD and MSA were significantly increased in fibrotic marrows regardless of etiology. [ncbi.nlm.nih.gov]

[…] the underlying etiology. [icd10data.com]

This case highlights an unusual etiology for pericardial effusion and tamponade, and further research should be considered with regards to JAK2 mutations in cases of myelofibrosis. [hsrc.himmelfarb.gwu.edu]

Even though the discovery of the Janus kinase 2 (JAK2), thrombopoietin receptor (MPL) and calreticulin (CALR) mutations have brought new insights into the complex pathogenesis of MPNs, the etiology of fibrosis is not well understood. [einstein.pure.elsevier.com]

Etiology The etiology of chronic IMF is unknown. Nonrandom chromosome abnormalities such as 9p, 20q-, 13q-, trisomy 8 or 9, or partial trisomy 1q are common, but no cytogenetic abnormality specific to the disease has been identified. [theoncologyinstitute.com]

Epidemiology

[…] permission © PEIR, University of Alabama at Birmingham, Department of Pathology Myelofibrosis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Myelofibrosis from other Diseases Epidemiology [wikidoc.org]

[…] granulocytes in bone marrow, marrow fibrosis, extramedullary hematopoiesis (EMH) Terminology Also called agnogenic (idiopathic) myeloid metaplasia, chronic idiopathic myelofibrosis, myelofibrosis / sclerosis with myeloid metaplasia, idiopathic myelofibrosis Epidemiology [pathologyoutlines.com]

Epidemiology of myeloproliferative neoplasms in the United States. Leukemia & Lymphoma. 2013;Early online: 1-6. [mpninfo.org]

Epidemiology The possible association between PH and CMPDs has been suggested by several case reports and small case series. [err.ersjournals.com]

Epidemiology and clinical relevance of mutations in post-polycythemia vera and post-essential thrombocythemia myelofibrosis. A study on 359 patients of the AGIMM group. Am J Hematol 2016; 91 : 681–686. 7. [nature.com]

Pathophysiology

[…] prostate) Infective – tuberculosis, fungal infections, HIV Metabolic – Gaucher’s disease Hematological malignancies – chronic myeloid leukemia, multiple myeloma, lymphomas Radiation, radiomimetic drugs Others – Sarcoidosis, congenital osteopetrosis Pathophysiology [pgblazer.com]

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology Myelofibrosis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology [wikidoc.org]

Metastatic carcinoma or infections with mycobacteria can also cause myelofibrosis. return to top Pathophysiology Fibrosis progressively displaces hematopoietic elements, inculding stem cells, from the marrow. [sharinginhealth.ca]

Bone marrow fibrosis: pathophysiology and clinical significance of increased bone marrow stromal fibres. Br J Haematol 2007;139:351–62. Web of Science Google Scholar 5. Farolino DL, Rustagi PK, Currie MS, Doeblin TD, Logue GL. [degruyter.com]

[…] with myeloid metaplasia, idiopathic myelofibrosis Epidemiology Often occurs in sixth and seventh decades No gender preference Sites Blood and bone marrow Spleen, in cases with EMH Other less common sites include liver, kidney, gastrointestinal tract Pathophysiology [pathologyoutlines.com]

Prevention

Prevention Prevention of secondary myelofibrosis The disease no effective preventive measures, early detection of early diagnosis is the key to prevention and treatment of this disease. [healthfrom.com]

| Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies Case Studies Case # 1 Related chapters Myelophthisic anemia [wikidoc.org]

REFERENCE BOOK Screening for Colorectal Cancer | CTFPHC REFERENCE BOOK Screening for Cognitive Impairment | CTFPHC REFERENCE BOOK Screening for Depression | CTFPHC REFERENCE BOOK Screening for Developmental Delay | CTFPHC Review Canadian Task Force on Preventive [qxmd.com]

Over time this destroys the normal bone marrow environment, preventing the production of adequate numbers of red cells, white cells and platelets. [leukaemia.org.au]

[…] way to prevent myelofibrosis, except in cases caused by exposure to radiation or industrial chemicals. [healthcommunities.com]

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