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Myeloproliferative Neoplasms Case Studies

Case Studies: Primary Myelofibrosis

Ruben A. Mesa, MD, FACP, considers data demonstrated by the COMFORT-I and COMFORT-II clinical trials in the management of a 72-year-old man diagnosed with primary myelofibrosis.

Primary Myelofibrosis

Case: 72-Year-Old Man Diagnosed With Primary Myelofibrosis

December 2018

  • A 72-year old man presents to primary care physician with complaints of fatigue, headache, night sweats, poor appetite, and 10-15lb weight loss over past few months; report of increased abdominal pain over the last 3 months
  • PMH: mild hypertension
  • PE: BP 130/85; Splenomegaly ~14 cm below left costal margin
  • Lab values:
    • HGB:  8.9 g/dL
    • Platelets:  189 x 109/L
    • WBC:  27.2 x 109/L
    • Serum LDH: 1500 U/L
    • Serum EPO: 11.5 mU/mL
  • Bone Marrow Biopsy:
    • MF-2
    • Circulating blasts, 1.2%
    • JAK-V617F mutation, del(20q)
  • Diagnosis:  Primary myelofibrosis
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