How is myelofibrosis treated?

Some people have regular examinations and blood tests while symptoms remain limited. Targeted therapy can reduce spleen enlargement and symptoms such as night sweats, itching or bone discomfort for suitable patients. Other medicines and transfusion support may be used for anaemia or low platelets, while treatment of infection and nutrition problems may also be needed.

An allogeneic stem cell transplant uses donor stem cells after conditioning treatment. It is the main treatment with potential for long-term disease control, but it carries substantial risks and is suitable only for selected people. The team considers age, general health, disease features and whether myelofibrosis developed after another blood disorder such as essential thrombocythaemia or polycythaemia vera.

Keep a record of abdominal swelling, night sweats, itching, bone pain, fatigue, fevers and weight changes. Attend blood-count appointments and ask how to manage medicines on days when you feel unwell. If your spleen is enlarged, ask which activities are safe and how to respond to new left-sided abdominal pain. Discuss transplant referral early if it is being considered.

Seek urgent help for sudden severe abdominal pain, fainting, chest pain, severe breathlessness, confusion or heavy bleeding. Contact your team promptly for fever, shaking chills, rapidly increasing abdominal swelling, new weakness or inability to drink. These symptoms may reflect infection, bleeding, clotting, spleen complications or worsening anaemia.

What is causing my symptoms and blood-count changes? What benefit should I expect from targeted therapy? How will you monitor my spleen and marrow? Am I suitable for an allogeneic transplant, and what preparation would it involve? Which symptoms need same-day advice?