High-dose intravenous methylprednisolone for idiopathic myelofibrosis.

In the annotation by Manoharan about mylelofibrosis in the July 1988 issue of the Journal. I could not find any comment on our approach (Ozsoylu & Ruacan, 1986: ihsoylu, 1988a. b) to the treatment of this disorder which is most promising. In addition to three children and an adult (&soylu, 1988a. b) in whom bone biopsy evaluation was carried out, a n 1 l-yearold girl with myelofibrosis (without bone biopsy findings) was -started on 25 February 1988 on high dose intravenous methylprednisolone: 30 mg/kg daily for 3 d, 2 0 mg/kg for 4 d, then subsequently 1 0 . 5 and 2 mg/kg per week followed by 1 mg/kg until the Hb concentration reached 1 2 g/dl. each dose being given once a day over 2-5 min. Her initial Hb concentration was 5 .7 g/dl, packed cell volume 20%, reticulocyte count 2.8% and white blood cell count 5 x 109/l. The peripheral blood smear contained a few normoblasts and tear drop cells. Within 34 d her Hb reached 1 2 g/dl (PCV 37%). Most recently (15 July 1988) she is on 2 5 mg prednisone every other day and haematologically normal (Hb 12.9 g/dl, PCV 38%; reticulocyte count 8%, WBC