Treatments for Myelofibrosis

Myelofibrosis is a bone marrow disease that interferes with the body's regular blood cell production. It causes significant bone marrow scarring, prompting severe anemia, weakness, fatigue and in most cases, an enlarged spleen and liver. If you have myelofibrosis, you can either get progressively worse with the potential to develop leukemia or live symptom-free for many years. Treatments aim to improve symptoms and will depend on your individual circumstances. If you are symptom-free, you usually will not require treatment and your doctor will regularly monitor your condition.

Blood Transfusion

• If you are severely anemic, recurring blood transfusions can up your red blood cell count and improve symptoms like weakness and tiredness. Certain medications can also treat severe anemia and your doctor will most likely try these first before moving to transfusions.

Androgen Therapy

• A combination therapy of the male hormone androgen and cortiosteroids like prednisone can encourage red blood cell production and improve severe anemia. If you respond to this treatment after a month, you will most likely continue taking androgen but slowly go off the steroids. Androgen can cause liver damage, produce masculine effects like unwanted body hair in women and promote the growth of prostate cancer.

Chemotherapy and Radiation Therapy

• The chemotherapy agent hydrea is used for this condition to decrease an enlarged spleen and platelet counts, counteract night sweats and weight loss and reduce bone marrow fibrosis (development of excess tissue that hardens). Radiation therapy can reduce the size of the spleen and treat bone pain. Both of these treatments can increase your chances of developing cancer.

Thalidomide and Steroids

• A combination of thalidomide and steroids can treat an enlarged spleen, improve anemia and blood cell counts and provide relief from weakness, fatigue, night sweat and difficulty breathing. It might also be an alternative to blood transfusions but is still in experimental stages for this use.

Splenectomy

• Your doctor might surgically remove your enlarged spleen if it is causing complications or has not responded to non-surgical treatments. Possible risks include infection, bleeding, blood clots that can lead to strokes and an increased risk of acute leukemia.

Stem Cell Transplantation

• A stem cell transplant can potentially cure myelofibrosis but carries lots of life-threatening risks. Before the procedure, you will need high doses of chemotherapy and radiation to destroy damaged cells, which can be very dangerous. After the operation, there is always a chance that your body will reject the new tissue which can lead to several complications and even death. Most people with this condition are not suitable candidates for this procedure due to their age and current state of health.