Reversal of transfusion dependence by tumor necrosis factor inhibitor treatment in a patient with concurrent rheumatoid arthritis and primary myelofibrosis

Abstract

Tumor necrosis factor α (TNF-α) is a proinflammatory cytokine with pleiotropic effects. Currently, TNF-α inhibitors are approved by the Food and Drug Administration for a number of diseases including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn disease, and ulcerative colitis. We report a patient with seropositive rheumatoid arthritis with concurrent primary myelofibrosis, who had transfusion-dependent anemia and moderate thrombocytopenia that reversed during treatment with adalimumab. Rheumatoid arthritis and myeloproliferative disorder or myelodysplastic disorder often coexist, and treatment with standard immunosuppressants becomes..