Transformation of primary myelofibrosis (PMF) to basophilic leukemia is very rare.We report the case of a 44-year-old man who had had PMF for 6 years. His hematopoiesis deteriorated with marked splenomegaly, requiring multiple red blood cell and platelet transfusions. Soon after splenectomy, progressive basophilia (32.3x109/L) developed, infiltrating the skin as well as the bone marrow.The patient underwent allogeneic bone marrow transplantation with cells from an HLA-matched sibling. Despite the presence of hyperhistaminemia (99.1 ng/mL) after conditioning with cyclophosphamide, the pregrafting and postgrafting periods were uneventful. Prophylactic administration of both H1 and H2 receptor antagonists and sufficient hydration appeared to be important.
Primary myelofibrosis Basophilic leukemia Allogeneic bone marrow transplantation Hyperhistaminemia
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