Myelofibrosis with myeloid metaplasia (MMM) is one of the Philadelphia-negative chronic myeloid disorders and is characterized by clonal megakaryocytic hyperplasia and secondary bone marrow fibrosis. biogenesis, or the formation of new blood vessels, may be integral to solid tumor growth and metastasis. Recent observations have underscored the biologic relevance of intratumoral angiogenesis and its potential impact on prognosis. Increased bone marrow angiogenesis has been demonstrated in a variety of hematologic disorders, including multiple myeloma. Angiogenesis can be quantitated by staining histological sections with antibodies that specifically identify endothelial cells. Two of the most important antibodies used are CD31 and CD34 antibodies, which are sensitive markers for vascular endothelium both benign and neoplastic. The number of microvessels can be estimated by many methods like hot spot method (counting microvessels in the area in which they are most abundant by the use of light microscope) and the use of computerized automatic vessel quantification using computerized image analysis system (using Global Lab Image II software) for estimation of many vessel parameters like microvessel density and inter capillary distance.