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March 4, 1983

Acute Myelofibrosis: Treatment With Allogeneic Bone Marrow Transplantation

Author Affiliations

From the Weingart Center for Bone Marrow Transplantation, Scripps Clinic and Research Foundation, La Jolla, Calif.

JAMA. 1983;249(9):1189-1190. doi:10.1001/jama.1983.03330330067039

ACUTE myelofibrosis is one of several names given to a disease first described in 1963 by Lewis and Szur,1 which they designated as malignant myelosclerosis. They reported five cases of an acute fatal illness characterized by anemia without adenopathy or splenomegaly, a peripheral blood picture like that of acute leukemia, and a bone marrow biopsy specimen demonstrating marked fibrosis. Since then, numerous cases have appeared in the literature and have been reviewed by Bearman et al,2 who have proposed a set of diagnostic criteria. The disease has been uniformly fatal despite treatment attempts with steroids, androgens, and chemotherapy, although no uniform attempt has been made to evaluate the results of treatment with combination chemotherapy. Recently, Smith et al3 and Wolf et al4 have reported treatment of five patients with acute myelosclerosis with chemotherapy and allogeneic bone marrow transplantation. Four patients had prompt engraftment and resolution of