Myeloproliferative neoplasms represent a variety of neoplasms that are characterized by proliferation of one or more hematopoietic lineages, which leads to myeloid cell expansion in the peripheral blood. There has been considerable progress in the last decade in understanding the molecular pathogenesis of these entities. JAK2 and MPL mutations are now incorporated in the classification of MPNs and may play a role in prognosis, especially in regard to venous thromboembolism, overall survival, and leukemic transformation. Several new drugs, especially those that target JAK1/2 enzymes, show promising results in the management of MPN.1,2 Hydroxyurea still plays a cornerstone role in the management of MPN because of its good control of peripheral blood count and its relatively safe profile. It has been studied in the prevention of cardiovascular complications in patients with polycythemia vera (PV) and essential thrombocythemia (ET), but there is scant literature on its effect on the bone marrow environment. We report an interesting case in which hydroxyurea was able to reverse bone marrow fibrosis (BMF)...
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