ArticleFrontiers in oncology2026
Case Report: The diagnostic and therapeutic crossroads: when myelofibrosis transforms into mixed phenotype acute leukemia.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Myelofibrosis (MF) is a myeloproliferative neoplasm characterized by the proliferation of fibrous tissue in the bone marrow. Transformation to acute leukemia, typically acute myeloid leukemia, represents a terminal event in its natural history; however, transformation to mixed phenotype acute leukemia (MPAL) is exceedingly rare. The diagnosis and treatment of MPAL are particularly challenging, especially in elderly patients with underlying MF. The clinical characteristics, treatment response, and prognosis of such cases remain unclear and are rarely reported. Case presentation: This article presents a retrospective analysis of a 75-year-old female patient who initially presented in October 2023 with splenomegaly and thrombocytopenia. Based on bone marrow morphology, biopsy (revealing Grade MF-2 fibrosis), and molecular testing (detecting a Discussion: This rare case offers several critical insights: 1) Rare Transformation Type: It clearly delineates the complete clinical and molecular evolutionary trajectory of PMF transforming into the rare MPAL, underscoring the importance of precise immunophenotyping during the blast phase of MF to identify atypical transformations. 2) Clonal Evolution Pattern: The molecular profile evolved from typical MPN driver mutations ( Conclusion: Transformation of MF to MPAL is a rare event associated with an poor prognosis. This study provides the detailed report of an elderly patient with MPAL arising from
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