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Hi Lacanada,
Like Birgitta, I too have some of the overlap mds/myelofibrosis diagnosis. I started with MDS - prominent dysplasia in the platelets and minimal in the red and white cells, second biopsy showed myelofibrosis with some dysplastic features, third and fourth showed MDS RCMD with grade 2-3 reticulin fibrosis. I had several proliferative characteristics in my platelet line in all biopsies and suffer from thrombocytopenia - other counts are normal. I am JAK2, MPL negative, have trisomy-8, am transfusion free thus far, 2 years after initial diagnosis.
The real interesting part is that treatment can be confusing for an overlap as some people will respond well to vidaza, others to thalidomide or revlimid, depending on the person.
The main thing is that i keep hearing from the doctors is that if you are going to go through transplant, it is important to begin treating before the reticulin fibrosis turns to collagen fibrosis, and of course before conversion to aml as that is where patients experience pronounced cytopenias and added complications.
Sorry for the long response that wasn't exactly on-target. The real answer to your question is that typically pure myelofibrosis does not have substantial dysplasia associated with it, and the presence of dysplasia lends itself to the MDS diagnosis.
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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