hematology and oncology
Myelophthisic Anemia
Introduction
Myelophthisic anemia is a normocytic, normochromic anemia that occurs when normal marrow space is infiltrated and replaced by nonhematopoietic or abnormal cells. Causes include tumors, granulomatous disorders, lipid storage diseases, and primary myelofibrosis. Bone marrow fibrosis often occurs as a secondary process as well. Splenomegaly may develop. Characteristic changes in peripheral blood include anisocytosis, poikilocytosis, and excessive numbers of red blood cell and white blood cell precursors. Diagnosis usually requires a bone marrow biopsy. Treatment is supportive and includes measures directed at the underlying disorder. (See also Overview of Decreased Erythropoiesis .) Myelophthisic anemia occurs when bone marrow space is infiltrated and replaced by nonhematopoietic or abnormal cells such as tumor cells or when bone marrow is replaced by fibrosis. Descriptive terms used in this anemia can be confusing. Myelofibrosis, which is replacement of marrow by fibrous tissue bands, may be Primary due to a bone marrow cancer. Primary Myelofibrosis (PMF) is a hematopoietic stem cell defect in which the fibrosis is a result of mutations in the Secondary due to causes outside the bone marrow, such as chronic autoimmune disease, or as a secondary process when marrow is infiltrated by tumor. Myelosclerosis is new bone formation that sometimes accompanies myelofibrosis. Myeloid metaplasia refers to extramedullary hematopoiesis in the liver, spleen, or lymph nodes that may accompany myelophthisis due to any cause. An old term, agnogenic myeloid metaplasia, indicates primary myelofibrosis with myeloid metaplasia. 