Abstract
A 77-year-old female presented in November 1984 with a one-month history of general malaise and low grade fever. On admission, the spleen was slightly enlarged or liver were not palpable. The peripheral blood showed marked leukocytosis with mild anemia and no tear-drop poikilocytosis. A few blast cells were myeloperoxidase-positive on electron microscopy. Repeated bone marrow aspirations were unsuccessful, and needle biopsy revealed a marked myelofibrosis accompanied with proliferation of three hematopoietic series. The diagnosis of “acute myelofibrosis” was made on the base of clinical and pathological criteria. During a few months after admission, she was treated with vincristin and prednisolone followed by OK-432 and low-dose cytosine arabinoside because of progressive pancytopenia. She died of sepsis caused by pneumonia in February 1985, shortly after hematological remission was achived. At autopsy, the bone marrow showed marked regression of fibrosis. Mild splenomegaly was found, but there was neither infiltration of leukemic cells nor extramedullary hematopoiesis in the liver and spleen.
