{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:42:08Z","timestamp":1786653728683,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 6-month-old boy presented with complaints of irritability, decreased feeding and high-grade intermittent fever for 20 days. He had moderate hepatosplenomegaly. Baseline cultures were negative but urinary Cytomegalovirus polymerase chain reaction was positive. He was started on Inj. Ganciclovir 5 mg\/kg\/dose twice daily for 14 days. Bone marrow aspiration (BMA) yielded a dry tap. Bone marrow biopsy (BMB) showed marked myelofibrosis with suppressed trilineage hematopoiesis. In view of persistent cytopenia and fever, a repeat BMA was done, revealing 22% blasts. Immunophenotyping by flow cytometry revealed 5.4% blasts with megakaryocytic differentiation. Subsequent cytogenetic analysis revealed Trisomy 8 and 19, with no evidence of Down syndrome. He was started on Down syndrome AML induction therapy followed by Cytarabine-Idarubicin-Etoposide therapy, but ultimately, he succumbed to infection and persistent disease. This case highlights the significance of looking for blasts even in a diluted marrow, so AMKL in a fibrotic marrow will not be missed.<\/jats:p>","DOI":"10.4103\/ijpm.ijpm_1027_24","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:00:09Z","timestamp":1768831209000},"page":"137-140","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Unravelling myelofibrosis in infants: A hidden pediatric challenge!"],"prefix":"10.4103","volume":"69","author":[{"given":"Shalini","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyavadhana","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahed Ali","family":"Qamer","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George Medical College, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Dhingra","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"R1-20260403","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1182\/blood-2005-06-2450","article-title":"Adult acute megakaryocytic leukemia: An analysis of 37 patients treated at M. 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