There is considerable interest in clinical conditions resembling leukemia or refractory anemia, in which investigation of the bone marrow reveals fibrosis or considerable diminution of the cellular elements. Until recently such conditions were properly identified only at postmortem examination, but at present the frequent use of sternal puncture or biopsy has made it possible to diagnose the condition during life at various stages of its development. According to our clinical observations, the results of microscopic studies on sternal bone and marrow obtained by biopsy and roentgen ray observations, two main disease entities are encountered. These are (1) osteopetrosis (Albers-Schönberg disease, or marble bone disease) and (2) myelofibrosis (myelosclerosis, leukoerythroblastic anemia, myelophthisic anemia, osteosclerotic anemia or nonleukemic myelosis). It is the purpose of this communication to report a case of osteopetrosis and 17 cases of myelofibrosis, in all except 4 of which the diagnosis was made during life.
The disease process