Bone marrow neoplastic

Bone marrow - neoplastic myeloid

Other AML entities defined by the WHO

Acute panmyelosis with myelofibrosis

Topic Completed: 1 March 2013

Minor changes: 9 December 2021

Copyright: (c) 2001-2018,, Inc.

PubMed Search: Acute panmyelosis with myelofibrosis

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Cite this page: Mihova D. Acute panmyelosis with myelofibrosis. website. Accessed January 28th, 2022.
Definition / general
  • Also called acute (malignant) myelofibrosis, acute (malignant) myelosclerosis, acute myelodysplasia with myelofibrosis
  • Now a distinct entity in WHO (2008) but not previously (Ann Hematol 2004;83:513, Leuk Lymphoma 2004;45:681)
  • Rare, rapid onset, aggressive, usually adults
  • Weakness, fatigue, fever, bone pain, pancytopenia; usually no marked splenomegaly
  • Median survival is 2 - 9 months
Case reports
Microscopic (histologic) description
  • Hypercellular marrow with erythroblasts, immature granulocytes, megakaryocytes
  • Prominent megakaryocytic abnormalities with variation in size and dysplastic changes, immature granulocytes with dysplasia and immature erythrocytes
  • Usually marked fibrosis (reticulin > collagen)
  • Aspirate smear is often hypocellular due to marked fibrosis
Microscopic (histologic) images

Bone marrow smear (Wright-Giemsa):
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Numerous blasts, some CD61+,
also abnormal erythroid
and granulocyte cells

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Blasts and more mature granulocytes, also
a large megakaryocyte with a poorly lobulated
nucleus and dispersed chromatin, occasional
neutrophils and late stage erythroblasts

Bone marrow biopsy:
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Partial replacement of marrow by
blasts and increased fibrous tissue

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Numerous blasts with some clustering

Lymph node biopsy:
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Total effacement by blasts, also
scattered megakaryocytes at
various stages of maturation

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Blasts have fine chromatin and small but
distinct nucleoli, mitotic figures are present

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Increase in coarse reticulin fibers

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Reticulin stain shows markedly
hypercellular marrow with proliferation
of blasts and maturing cells, and
increase in coarse reticulin fibers

Positive stains
Differential diagnosis
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