• Mengyu Xiao, Ling Qin, Xiaona Niu, Pan Zhou, Junwei Niu, Shengjie Wei, Dan Li, Liurui Dou, Wanjun Zhang, Lei Zhang, Kai Sun, and Yanliang Bai.
• Department of Hematology, Zhengzhou University People's Hospital.
• Medicine (Baltimore). 2021 Apr 2; 100 (13): e24567e24567.

RationaleAcute promyelocytic leukemia (APL) with myelofibrosis (MF) is rare, and only 14 cases have been reported in the literature to date.Patient ConcernsA 42-year-old woman was admitted to the hospital with easy bruising and excessive bleeding. With the remission of the primary disease during treatment, the degree of fibrosis did not decrease, but worsened progressively.DiagnosisThe woman was diagnosed with acute promyelocytic leukemia with secondary myelofibrosis.InterventionsAll-trans retinoic acid (ATRA) was discontinued after 6 months of complete remission of APL. Arsenic trioxide (ATO) was discontinued because of supraventricular tachycardia 9 months after complete remission of APL.OutcomesAfter withdrawal of ATRA for 2 months, the degree of fibrosis was significantly alleviated, and after withdrawal of ATRA for 8 months and ATO for 5 months, bone marrow biopsy showed no reticular fiber deposition.LessonsIn this case report and review of an additional 14 cases of APL with MF, we highlighted the importance of the degree of MF to be evaluated by bone marrow biopsy at the time of bone marrow aspiration when APL is suspected. If MF is present, the type of MF should be determined in a timely manner, and appropriate intervention measures should be taken accordingly.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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