Myelofibrosis historical perspective

The first description of primary myelofibrosis (PMF) is credited to a German surgeon, Gustav Heuck, who described the concept in 1879. Additional work and discoveries started to get documented at the beginning of the twentieth century. The substantial contribution came from Max Askanazy, a German pathologist and Herbert Assmann, an Internist from Germany. The condition was given several pseudonyms before the International Working Group for Myelofibrosis Research and Treatment decided in 2006 to use the term primary myelofibrosis (PMF).

• In 1879, Gustav Heuck, a German surgeon, was the first to describe the notion of myelofibrosis. He explained the idea under the title of “Two cases of leukemia with peculiar blood and bone marrow findings”. Heuck described two patients with massive splenomegaly, increased number of morphologically abnormal leukocytes, and nucleated red blood cells. He observed that the clinical findings in these two patients were different from those described for chronic myelogenous leukemia (CML) because of the presence of bone marrow fibrosis and extensive extramedullary hematopoiesis (EMH). He also noted osteosclerosis in an autopsy report.^[1]
• In 1904, Max Askanazy, a German pathologist, reported a case with significant extramedullary hematopoiesis (EMH) of the liver and diffuse bone marrow fibrosis.^[2]
• In 1907, Herbert Assmann, an internist from Germany, described another case of extramedullary hematopoiesis (EMH) and bone marrow fibrosis which he went on and named “osteosclerotic anemia“. Later on, it was referred to as “Heuck–Assmann syndrome”.^[2]
• In 1914, Hans Hirschfeld, a German hematologist further elaborated the splenic pathology in primary myelofibrosis (PMF).
• In 1951, William Dameshek, an internationally renowned American hematologist, grouped together primary myelofibrosis (PMF), chronic myelogenous leukemia (CML), polycythemia vera (PV), and essential thrombocythemia (ET) and classified them as “myeloproliferative disorders“.^[3][4]
• In 1975, Murray N Silverstein, an American hematologist, published his classic monograph and described most of the modern natural history and treatment of primary myelofibrosis (PMF).^[5]