Tratamiento de la mielofibrosis idiopática crónica con bajas dosis de talidomida.: Comunicación de 2 casos

chronic idiopathic myelofibrosis (cim) also known as agnogenic myeloid metaplasia, primary myelosclerosis with myeloid metaplasia and idiopathic myelofibrosis is characterized by splenomegalia, extramedullary hematopoiesis, progressive anemia, leukoerythroblastosis reaction, tears white cells in peripheral blood and bone marrow fibrosis. there have been modest benefits with anemia therapies (erythropoietin and androgens) or the splenomegalia (hydroyurea, alpha-interferon). neither of these regimes confers survival benefit or a demonstrable change in extramedullary fibrosis. the lack of an effectiveness treatment for this disease has leads us to study its pathogenic mechanisms and the use of new therapeutical alternatives. two cases are described diagnosed with cim with a course of 9 and 5 years and due to the high transfusion requirements and a significant splenomegalia it was necessary to administer a treatment with thalidomide and prednisone. combination treatment achieved an increase in hemoglobin figures and of platelet counts and a decrease and elimination of transfusion requirements.