Clinical, histopathologic, and genetic features of pediatric primary myelofibrosis--an entity different from adults

Am J Hematol. 2012 May;87(5):461-4. doi: 10.1002/ajh.23140. Epub 2012 Mar 3.


Primary myelofibrosis is a chronic myeloproliferative neoplasm characterized by cytopenias, leukoerythroblastosis, extramedullary hematopoiesis, hepatosplenomegaly and bone marrow fibrosis. Primary myelofibrosis is a rare disorder in adults; children are even less commonly affected by this entity, with the largest pediatric case series reporting on three patients. Most literature suggests spontaneous resolution of myelofibrosis without long term complications in the majority of affected children. We describe the clinical, pathologic, and molecular characteristics and outcomes of nineteen children with primary myelofibrosis treated in our center from 1984 to 2011. Most patients had cytopenia significant enough to require supportive therapy. No child developed malignant transformation and only five of the 19 children (26%) had spontaneous resolution of disease. Sequence analyses for JAK2V617F and MPLW515L mutations were performed on bone marrow samples from 17 and six patients, respectively, and the results were negative. In conclusion, analysis of this large series of pediatric patients with primary myelofibrosis demonstrates distinct clinical, hematologic, bone marrow, and molecular features from adult patients.

MeSH terms

  • Adolescent
  • Age of Onset
  • Anemia, Myelophthisic / etiology
  • Bone Marrow / pathology
  • Bone Marrow Examination / methods
  • Child
  • Child, Preschool
  • Collagen / analysis
  • DNA Mutational Analysis
  • Disease Progression
  • Eosinophilia / etiology
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Infant
  • Infant, Newborn
  • Janus Kinase 2 / genetics
  • Male
  • Mutation, Missense
  • Postoperative Complications / mortality
  • Primary Myelofibrosis / epidemiology*
  • Primary Myelofibrosis / genetics
  • Primary Myelofibrosis / pathology
  • Primary Myelofibrosis / surgery
  • Receptors, Thrombopoietin / genetics
  • Remission, Spontaneous
  • Reticulin / ultrastructure
  • Retrospective Studies
  • Splenomegaly / etiology
  • Staining and Labeling
  • Treatment Outcome


  • Receptors, Thrombopoietin
  • Reticulin
  • MPL protein, human
  • Collagen
  • JAK2 protein, human
  • Janus Kinase 2