Myelofibrosis Secondary to Renal Osteodystrophy

Nomura, Shinsuke; Ogawa, Yoji; Osawa, Gengo; Katagiri, Makoto; Harada, Tanekazu; Nagahana, Haruki

doi:10.1159/000188961

Cited by 31 publications

(32 citation statements)

References 9 publications

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“…However, this may be overlooked in predialysis CKD. While there is no proof of a direct EPO inhibition by parathyroid hormone (PTH), synergism between EPO and vitamin D has been demonstrated [36,37]. In addition, hyperphosphatemia decreases the bone marrow response to ESA [38].…”

Section: Oxidative Inflammationmentioning

confidence: 99%

Resistance to erythropoietin-stimulating agents: etiology, evaluation, and therapeutic considerations

Bamgbola

2011

Pediatr Nephrol

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Routine clinical and laboratory assessments facilitate diagnosis of erythropoietin (EPO) resistant anemia by allowing early identification of patients with non-adherence. Any new event that impairs response to EPO (e.g., catheter sepsis) must be promptly controlled. Because of the confounding interaction of its risk factors, initial evaluation should include nutrition, dialysis adequacy, hemorrhage, bone mineral metabolism, and inflammation. Prevention of EPO resistance is more cost effective and should include adequate dialysis and nutritional supplements. Blood loss during hemodialysis (HD) procedures should be minimized. If there is laboratory proof of iron deficit intravenous repletion is most effective. Oxidative stress may be attenuated by vitamins E and C, while optimal control of hyperparathyroidism will enhance EPO stimulation. Contaminated dialysates should be suspected if there is EPO-stimulating agents (ESA) resistance at the same time among most members of a dialysis program. Heavy metal toxicity should be suspected in high-risk patients. The impact of co-morbidities such as hemoglobinopathy, glucose 6 phosphate dehydrogenase (G6PD) deficiency and connective tissue diseases must be excluded in an appropriate setting. In conclusion, given the multiple risk factors of EPO resistance promotion of the overall health status will most likely yield an enduring benefit. Finally, there are experimental trials of gene-based (therapy) to stimulate endogenous EPO synthesis with the goal of avoiding the off-target effect of excessive dosing.

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Section: Oxidative Inflammationmentioning

confidence: 99%

Resistance to erythropoietin-stimulating agents: etiology, evaluation, and therapeutic considerations

Bamgbola

2011

Pediatr Nephrol

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“…Chronic myeloproliferative neoplasms (polycythemia vera, essential thrombocythemia, or chronic myeloid leukemia) represent one of the frequent causes of secondary MF followed by autoimmune myelofibrosis or other nonhematologic disorders [2]. The association between MF and lymphoproliferative disease is a very rare event and is not well described except in multiple myeloma [3] and hairy cell leukemia.…”

Section: Introductionmentioning

confidence: 99%

Myelofibrosis-Associated Lymphoproliferative Disease: Retrospective Study of 16 Cases and Literature Review

Etienne

Gruson

Chatelain

et al. 2009

Advances in Hematology

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Background. To better describe the clinical, biological, and the outcome of non-Hodgkin's lymphoma (NHL) with, at the initial presentation, bone marrow fibrosis (MF). Patients and Methods. From January 2001 to January 2007, 16 eligible patients with NHL and MF were retrieved from the Pathology Department of the University hospital of Amiens. Median age of patients was 62 years (range 16–74) with a sex ratio male/female of 3. Results. MF is associated with all types of lymphoma predominantly with B-cell phenotype and it seems to be more associated with low-grade NHL. B-symptoms are more frequent at diagnosis and more patients presented with an elevated LDH level. JAK-2 was negative in the 10 patients analysed. Two patients presented with features of primary MF with no evidence of lymphoma. Overall response rate was 94% after the first line of therapy with regression or improvement of MF. Relapse occurred in 8 patients (47%) with recurrence of MF in all of them. After a median follow-up of 42 months, 12 patients were alive with an overall survival rate for the entire group of 75%. Conclusions. MF-associated NHL is a rare manifestation which may be associated with all types of NHL and its presence does not seem to confer a poor prognosis. A search for lymphoproliferation should be considered when the cause of MF is not apparent.

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“…, 1998). Secondary HP presenting with hypocalcemia and subsequent increased PTH, is mainly identified in patients with chronic renal failure, which has been associated with variable degrees of bone marrow fibrosis, which causes anemia, thrombocytopenia and eventually pancytopenia (Nomura et al. , 1996).…”

Section: Introductionmentioning

confidence: 99%

Pancytopenia and secondary myelofibrosis could be induced by primary hyperparathyroidism

Lim

Park

et al. 2007

Int J Lab Hematology

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Hyperparathyroidism may be a precipitating factor important to the development of myelofibrosis: however, there has been only a few reports regarding myelofibrosis secondary to primary hyperparathyroidism. Recently, a rare case of pancytopenia caused by myelofibrosis in a 41-year-old woman who complained of general weakness and arthralgia presented to our clinical service. The patient was diagnosed with primary hyperparathyroidism with pancytopenia. Bone marrow biopsy revealed myelofibrosis. Right parathyroidectomy was performed and a parathyroid adenoma was totally excised. After surgery, the CBC counts and other clinical abnormalities gradually improved without further intervention. We concluded that the pancytopenia was because of bone marrow fibrosis resulting from primary hyperparathyroidism. Therefore, physicians should consider myelofibrosis secondary to primary hyperparathyroidism as a cause of pancytopenia in hypercalcemic patients, even though it is rare.

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Myelofibrosis Secondary to Renal Osteodystrophy

Cited by 31 publications

References 9 publications

Resistance to erythropoietin-stimulating agents: etiology, evaluation, and therapeutic considerations

Resistance to erythropoietin-stimulating agents: etiology, evaluation, and therapeutic considerations

Myelofibrosis-Associated Lymphoproliferative Disease: Retrospective Study of 16 Cases and Literature Review

Pancytopenia and secondary myelofibrosis could be induced by primary hyperparathyroidism

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