Myelofibrosis: Report of five cases treated with thalidomide

Letizia Canepa, Filippo Ballerini, Riccardo Varaldo, Raffaella Grasso

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Myelofibrosis with myeloid metaplasia (MMM) is a clonal stem cell disorder including idiopathic and associated (postthrombocythemic and postpolycythemic) myeloid metaplasia. The only chance for achieving a cure in MMM is high doses chemotherapy followed by allogeneic transplantation, but the high median age of the patients at presentation precludes them from this possibility. Immunological and angiogenetic factors are supposed to play an important role in the pathogenesis of the disease. MMM shows biological features indicating disruption of the immune response (Coombs positive hemolytic anemia, antinuclear antibodies,lupus-type anticoagulant),whereas angiogenesis could act through the positive relationship between leukemic and endothelial cells for the production of mutually mitogenic growth factors.Recently trials have been reported regarding use of thalidomide in several hematological malignancies. Thalidomide appears inhibit angiogenesis and alphaTNF production.Three patients (pts) with idiopathic myelofibrosis (iMF) and two with other myeloproliferative disorders with associated MF (aMF) were treated with thalidomide, starting with 200 mg/die and increasing by 100 mg every two weeks, according to tolerance and response. Two iMF pts were therapy naive, whereas the other three (1 iMF and 2 aMF) failed to respond to previous therapy. All pts showed hepatosplenomegaly and three were transfusion dependent (all iMF pts). One patient had abnormal karyotype (47,XY,+8). Two iMF patients with Hb levels

Original languageEnglish
Issue number11 PART II
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Hematology


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