TY - CHAP M1 - Book, Section TI - Primary Myelofibrosis A1 - Lichtman, Marshall A. A1 - Kaushansky, Kenneth A1 - Prchal, Josef T. A1 - Levi, Marcel M. A1 - Burns, Linda J. A1 - Linch, David C. PY - 2022 T2 - Williams Manual of Hematology, 10e AB - Primary myelofibrosis is a chronic myeloid neoplasm that originates in mutations in a multipotential hematopoietic cell, possibly the lymphohematopoietic stem cell. The disease is characterized by (1) anemia; (2) splenomegaly; (3) increased CD34+ cells, immature granulocytes, erythroid precursors, and teardrop-shaped red cells in the blood; (4) increased dysmorphic megakaryocytes, the cytokines from which induce marrow fibrosis; and (5) osteosclerosis.The designation (name) for this clonal neoplasm has been problematic throughout the years. The decision to call it primary myelofibrosis is a failure to understand its pathobiology. There are no tumors of connective tissue fibers. The disease is principally a profound, neoplastic expression of exaggerated and profoundly disordered hematopoiesis, with disordered megakaryocytopoiesis being the most prominent and consistent finding and the basis for the fibrosis characteristic of the disease. The primary abnormality of megakaryocytopoiesis is amplified by the fact that CD34+ cells from patients with this disease, when grown in culture, generate 24-fold the clonal megakaryocytes as the number of megakaryocytes generated by normal CD34+ cells. Thus, this disease most closely conforms to chronic megakaryocytic leukemia, using the standard convention of naming a myeloid neoplasm by its dominant morphologic expression (eg, monocytic leukemia, erythroid leukemia). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/18 UR - hemonc.mhmedical.com/content.aspx?aid=1189334756 ER -