Myelodysplastic Phase During a Complete Course of Polycythemia Vera: Confirming Azacytidine Effectiveness on Myelodysplastic but not on Myeloproliferative Clone

Case Report

Volume 3, Issue 3 (March Issue)

Myelodysplastic Phase During a Complete Course of Polycythemia Vera: Confirming Azacytidine Effectiveness on Myelodysplastic but not on Myeloproliferative Clone

Gianmario Pasqualone¹, Marcello Roberto¹, Vincenzo Fraticelli², Maria Pia Petrilli², Cristiana Gasbarrino², Gianfranco Giglio³, Vincenzo Martinelli^1,4* and Sergio Storti⁵

¹Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
²Hematologist, Oncohematology Department, Gemelli Molise SpA, Campobasso, Italy
³Hematologist, Oncology Operating Unit, “Antonio Cardarelli” Hospital, Azienda Sanitaria Regionale del Molise (ASReM), Campobasso, Italy
⁴Department of Medicine and Surgery, Haematopoietic Stem Cell Transplant Center; University of Naples Federico II, Naples, Italy
⁵Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy

^*Corresponding author: Vincenzo Martinelli, Department of Medicine and Health Sciences, University of Molise – Contrada Tappino, 86100 Campobasso (CB); Department of Medicine and Surgery, University of Naples Federico II – Via Sergio Pasini, 5 – 80131 Napoli (NA), Italy, Tel: +390817464392; E-mail: vincenzo.martinelli@unimol.it

Author’s Contributions: Pasqualone G and Roberto M contributed equally to this case report.

Received: March 22, 2021; Accepted: March 28, 2021; Published: April 11, 2021

Citation: Pasqualone G, Roberto M, Fraticelli V, et al. Myelodysplastic Phase During a Complete Course of Polycythemia Vera: Confirming Azacytidine Effectiveness on Myelodysplastic but not on Myeloproliferative Clone. Clin Image Case Rep J. 2021; 3(3): 153.

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Myelodysplastic Phase During a Complete Course of Polycythemia Vera: Confirming Azacytidine Effectiveness on Myelodysplastic but not on Myeloproliferative Clone

Abstract

This report describes a patient with polycythemia vera harboring JAK2V617F mutation, whose condition progressed to myelodysplastic syndrome after 15 years. Several months after initiation of the hypomethylating agent azacytidine, the bone marrow was reset in a polycythemia vera pattern, thus displaying the re-occurrence of neoplastic stem cell with JAK2V617F. Interestingly, a subsequent bone marrow reassessment showed evolution to myelofibrosis: this evidence could be explained through the ability of azacytidine to manage the myelodysplastic clone in the bone marrow, thereby allowing the natural course of the myeloproliferative disorder.

Keywords: Polycythemia vera; Azacytidine; Myelodysplastic syndrome; MDS-EB-2; Myelofibrosis; JAK2^V617F