JAK Inhibition for the Management of Primary Myelofibrosis

Case: 66-Year-Old Man Diagnosed With Primary Myelofibrosis

January 2019

• A 66-year old man presents to primary care physician with complaints of fatigue, headache, and abdominal discomfort when taking deep breaths
• PMH: depression
• PE: Splenomegaly ~7 cm below left costal margin
• Lab values:
  • HGB: 9.2 g/dL
  • Platelets: 242 x 10⁹/L
  • WBC: 26.2 x 10⁹/L
  • Serum LDH: 1400 U/L
  • Serum EPO: 10.9 mU/mL
• Bone Marrow Biopsy:
  • MF-3
  • Circulating blasts, 1.1%
  • JAK V617Fmutation; trisomy 8
• Peripheral Blood Smear: leukoerythroblastosis
• Diagnosis: Primary myelofibrosis