Myelophthisis is a type of bone marrow failure that occurs when there is an abnormal displacement of hematopoietic cells by nonhematopoietic cells.


Myelophthisis most often occurs with metastatic cancer to the bone marrow. Some of the effect of metastatic cancer is a result of direct tumor effect, some from marrow fibrosis and some from a depression of medullary hematopoiesis..


Features of myelophthisis:

(1) leukoerythroblastic peripheral blood smear

(2) microangiopathic hemolytic anemia with teardrop-shaped red blood cells

(3) thrombocytopenia

(4) extramedullary hematopoiesis with variable splenomegaly and hepatomegaly

(5) increase in circulating CD34+ cells


Differential diagnosis:

(1) TTP

(2) other causes of leukoerythroblastosis


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