A 56-year-old male known to have Primary Myelofibrosis (PMF) on ruxolitinib presented with flank pain and high creatinine, MRI abdomen showed features of extramedullary hematopoiesis. Therefore, Extramedullary hematopoiesis should be considered in patient with PMF presenting with deranged renal function.

A 48-year-old male diagnosed with Acute promyelocytic leukemia (APL) started on all-trans retinoic acid and arsenic trioxide, developed typical symptoms of differentiation syndrome, and improved dramatically on steroids. Hence, any APL patient started on chemotherapy, needs to be monitored closely for developing differentiation syndrome and to start steroid upon suspicion.