Acute panmyelosis with myelofibrosis: Difference between revisions

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{{Short description|A rare hematological disorder}}
| name            = Acute panmyelosis with myelofibrosis
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'''Acute panmyelosis with myelofibrosis''' ('''APMF''') it is a poorly defined disorder that arises as either a clonal disorder, or following toxic exposure to the [[bone marrow]].<ref>{{cite book |vauthors =Hoffman R, Benz E, Shattil S, Furie B, Cohen H |title=Hematology: Basic Principles and Practice |publisher=Churchill Livingstone |year=2004 |edition=4th}}</ref>
'''Acute panmyelosis with myelofibrosis''' (APMF) is a rare and aggressive [[hematological disorder]] characterized by the rapid proliferation of abnormal [[hematopoietic stem cells]] in the [[bone marrow]], leading to [[pancytopenia]] and extensive [[myelofibrosis]]. This condition is classified under the category of [[acute myeloid leukemia]] (AML) and is considered a subtype of [[acute leukemia]].


==Signs and symptoms==
==Pathophysiology==
Bone marrow biopsy shows abnormal [[megakaryocyte]]s, macrocytic erythropoiesis, and defects in [[neutrophil]] production and fibrosis of the marrow (myelofibrosis).
APMF involves the abnormal growth of [[myeloid lineage]] cells in the bone marrow. The proliferation of these cells is accompanied by the deposition of [[fibrous tissue]], which disrupts normal [[hematopoiesis]]. The excessive fibrosis in the bone marrow leads to a reduction in the production of normal [[blood cells]], resulting in [[anemia]], [[thrombocytopenia]], and [[leukopenia]]. The exact cause of APMF is not well understood, but it is believed to involve genetic mutations that affect the regulation of cell growth and differentiation.


Clinically patients present with reduction in the count of all blood cells ([[pancytopenia]]), a very few blasts in the peripheral blood and no or little [[spleen]] enlargement ([[splenomegaly]]).
==Clinical Presentation==
Patients with APMF typically present with symptoms related to bone marrow failure, such as fatigue, weakness, easy bruising, and increased susceptibility to infections. The rapid progression of the disease often leads to severe [[pancytopenia]], which can be life-threatening if not treated promptly.


Cells are usually [[CD34]] positive.<ref name="pmid15578075">{{cite journal |vauthors =Orazi A, O'Malley DP, Jiang J |title=Acute panmyelosis with myelofibrosis: an entity distinct from acute megakaryoblastic leukemia |journal=Mod. Pathol. |volume=18 |issue=5 |pages=603–14 |date=May 2005 |pmid=15578075 |doi=10.1038/modpathol.3800348|display-authors=etal|doi-access=free }}</ref>
==Diagnosis==
The diagnosis of APMF is based on a combination of clinical findings, laboratory tests, and bone marrow examination. A bone marrow biopsy is essential to confirm the presence of panmyelosis and myelofibrosis. The biopsy typically shows hypercellular marrow with increased fibrous tissue and abnormal myeloid precursors. Additional tests, such as [[cytogenetic analysis]] and [[molecular testing]], may be performed to identify specific genetic abnormalities associated with the disease.


==Prognosis and treatment==
==Treatment==
Median survival is about 9 months.{{Citation needed|date=December 2008}}
The treatment of APMF is challenging due to its aggressive nature. Therapeutic options may include [[chemotherapy]] regimens similar to those used for other forms of acute myeloid leukemia. In some cases, [[hematopoietic stem cell transplantation]] may be considered, especially for younger patients or those with a suitable donor. Supportive care, including blood transfusions and treatment of infections, is also an important aspect of managing the disease.


Autologous stem cell transplantation has been used in treatment.<ref name="pmid17194659">{{cite journal |vauthors =Ngirabacu MC, Ravoet C, Dargent JL |title=Long-term follow-up of autologous peripheral blood stem cell transplantation in the treatment of a patient with acute panmyelosis with myelofibrosis |journal=Haematologica |volume=91 |issue=12 Suppl |pages=ECR53 |date=December 2006 |pmid=17194659 |url=http://www.haematologica.org/cgi/pmidlookup?view=long&pmid=17194659|display-authors=etal}}</ref>
==Prognosis==
The prognosis for patients with APMF is generally poor, with a median survival of less than one year. The aggressive nature of the disease and the extensive fibrosis in the bone marrow contribute to the difficulty in achieving long-term remission. Early diagnosis and treatment are crucial to improving outcomes, but the overall prognosis remains challenging.


==Terminology==
==Related pages==
Controversy remains today whether this disorder is a subtype of [[acute myeloid leukemia]] or [[myelodysplastic syndromes]]; however, it is currently classified as a form of AML.<ref>{{cite journal |vauthors =Thiele J, Kvasnicka HM, Schmitt-Graeff A |title=Acute panmyelosis with myelofibrosis |journal=Leuk. Lymphoma |volume=45 |issue=4 |pages=681–7 |date=April 2004 |pmid=15160939 |doi=10.1080/10428190310001625692 |url=http://informahealthcare.com/doi/abs/10.1080/10428190310001625692}}</ref><ref>{{cite journal |vauthors =Thiele J, Kvasnicka HM, Zerhusen G |title=Acute panmyelosis with myelofibrosis: a clinicopathological study on 46 patients including histochemistry of bone marrow biopsies and follow-up |journal=Ann. Hematol. |volume=83 |issue=8 |pages=513–21 |date=August 2004 |pmid=15173958 |doi=10.1007/s00277-004-0881-8 |display-authors=etal}}</ref>
* [[Acute myeloid leukemia]]
* [[Myelofibrosis]]
* [[Hematopoietic stem cell transplantation]]
* [[Pancytopenia]]


==See also==
[[Category:Hematology]]
* [[List of hematologic conditions]]
[[Category:Leukemia]]
 
[[Category:Rare diseases]]
==References==
{{Reflist}}
 
==See also==
*[[Acute myeloid leukemia]]
*[[Panmyelosis]]
*[[Myelofibrosis]]
 
== External links ==
{{Medical resources
|  DiseasesDB    = 
|  ICD10          = {{ICD10|C|94|4|c|81}}
|  ICD9          = {{ICD9|238.79}}
|  ICDO          =  9931/3
|  OMIM          = 
|  MedlinePlus    = 
|  eMedicineSubj  = 
|  eMedicineTopic = 
|  MeshID        =
}}
{{Myeloid malignancy}}
 
[[Category:Acute myeloid leukemia]]
{{dictionary-stub1}}
{{No image}}

Revision as of 19:08, 22 March 2025

A rare hematological disorder


Template:Medical condition (new)

Acute panmyelosis with myelofibrosis (APMF) is a rare and aggressive hematological disorder characterized by the rapid proliferation of abnormal hematopoietic stem cells in the bone marrow, leading to pancytopenia and extensive myelofibrosis. This condition is classified under the category of acute myeloid leukemia (AML) and is considered a subtype of acute leukemia.

Pathophysiology

APMF involves the abnormal growth of myeloid lineage cells in the bone marrow. The proliferation of these cells is accompanied by the deposition of fibrous tissue, which disrupts normal hematopoiesis. The excessive fibrosis in the bone marrow leads to a reduction in the production of normal blood cells, resulting in anemia, thrombocytopenia, and leukopenia. The exact cause of APMF is not well understood, but it is believed to involve genetic mutations that affect the regulation of cell growth and differentiation.

Clinical Presentation

Patients with APMF typically present with symptoms related to bone marrow failure, such as fatigue, weakness, easy bruising, and increased susceptibility to infections. The rapid progression of the disease often leads to severe pancytopenia, which can be life-threatening if not treated promptly.

Diagnosis

The diagnosis of APMF is based on a combination of clinical findings, laboratory tests, and bone marrow examination. A bone marrow biopsy is essential to confirm the presence of panmyelosis and myelofibrosis. The biopsy typically shows hypercellular marrow with increased fibrous tissue and abnormal myeloid precursors. Additional tests, such as cytogenetic analysis and molecular testing, may be performed to identify specific genetic abnormalities associated with the disease.

Treatment

The treatment of APMF is challenging due to its aggressive nature. Therapeutic options may include chemotherapy regimens similar to those used for other forms of acute myeloid leukemia. In some cases, hematopoietic stem cell transplantation may be considered, especially for younger patients or those with a suitable donor. Supportive care, including blood transfusions and treatment of infections, is also an important aspect of managing the disease.

Prognosis

The prognosis for patients with APMF is generally poor, with a median survival of less than one year. The aggressive nature of the disease and the extensive fibrosis in the bone marrow contribute to the difficulty in achieving long-term remission. Early diagnosis and treatment are crucial to improving outcomes, but the overall prognosis remains challenging.

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