What Are the Symptoms of Myelofibrosis?

Many people who have this rare blood cancer don’t feel symptoms for years because it usually grows so slowly. Over time, myelofibrosis (MF) can affect the way your body makes the three types of blood cells: red, white, and platelets. That can cause symptoms or illnesses.

Both men and women can get it, usually around age 60. Kids rarely get it. Symptoms are similar for everyone.

Symptoms in Your Blood

They’re related to changes in how your body makes blood cells.

You can get anemia if you don’t make enough red blood cells. It could make you feel tired or weak. You may also have symptoms like:

  • Shortness of breath
  • Irritability
  • Headaches
  • Pale skin
  • Dizziness
  • Irregular heartbeats
  • Cold hands or feet

Infections are more likely if you have too many white blood cells. They usually fight off ailments like colds or flu. But if you have more than you should, they might not work the right way. You could pick up germs more easily and feel sicker than usual.

Bleeding can be a problem if MF lowers the amount of platelets you make. Your blood won’t clot normally. This can result in:

  • Easy bruising, even after a minor bump
  • Easy bleeding
  • Bleeding gums
  • Sudden nosebleeds

Symptoms in Your Body

As your disease gets worse, you spleen can become enlarged. This can make the area below your ribs on the left side feel painful, bloated, or full. Your left shoulder or back might also hurt.

You may also have an enlarged liver or high blood pressure in the veins that enter it. This means it can’t work like it should. And that might cause you to bleed in your digestive system. You might feel discomfort or bloating in your middle.

Over time you might notice:

  • Major weight loss
  • Itching
  • Coughing up blood
  • Seizures
  • Pressure on your spinal cord
  • Bone and joint pain
  • Easy bleeding that could make surgery risky
  • Pain and swelling in your joints, called gout

Some people can also get acute leukemia, a serious type of blood cancer. It can grow quickly and be life-threatening.

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How to Ease Your Symptoms

You have many options to ease your symptoms or treat serious problems.

Anemia: Iron, folic acid, and vitamin B12 supplements may provide the nutrients you need to make red blood cells. If your anemia is more severe, your doctor may suggest:

  • Blood transfusions
  • Steroids
  • Erythropoietin, a hormone replacement
  • Androgen therapy, another hormone replacement
  • Chemotherapy drugs
  • Drugs that affect your immune system (your doctor might call them immunomodulators)

Enlarged spleen: You could need to have surgery to remove your spleen. The doctor will watch you carefully afterward to make sure you don’t have bleeding, clots, or liver problems.

Some drugs can shrink your spleen. Your doctor might try chemotherapy or immunomodulators. Radiation might help, too.

Blood clots: Your doctor may prescribe a low-dose of aspirin or the medication hydroxyurea (Droxia, Hydrea) to help prevent blood clots.

Gene mutations: Your doctor may put you on ruxolitinib (Jakafi). It targets the mutations experts believe cause myelofibrosis. Side effects can include:

  • Bleeding
  • Infection
  • Bruising
  • Dizziness
  • Headaches

The only treatment that could potentially cure the disease is a stem cell transplant. But there's a high risk of life-threatening side effects if your new stem cells react against healthy tissues. So if you're older or have other health problems, this may not be an option for you.

Your team may suggest special care to help relieve pain and other symptoms -- called supportive or palliative care -- either on its own or in combination with other treatments.

Talk to your doctor about what's best for you.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on December 26, 2017

Sources

SOURCES:

Leukemia and Lymphoma Society: “Myelofibrosis,” “Myelofibrosis Facts.”

Myeloproliferative Research Foundation: “Primary Myelofibrosis (PMF).”

National Heart, Lung and Blood Institute: “What Are the Signs and Symptoms of Anemia?”

National Organization for Rare Disorders: “Primary Myelofibrosis.”

MayoClinic.org: “Myelofibrosis: Complications.”

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