What are the treatment options for myelofibrosis?

Myelofibrosis affects blood-making tissue and can cause anaemia, low blood counts, an enlarged spleen, bone discomfort, night sweating or weight changes. A haematology team reviews symptoms, examination findings, blood tests and disease risk before recommending a plan. Some people are monitored when symptoms are limited. Targeted therapy can help reduce spleen enlargement or ease constitutional symptoms; it does not suit every person and needs monitoring for blood-count changes.

Allogeneic stem cell transplant uses blood-forming cells from a donor and is the treatment with potential to change the disease course, but it involves intensive preparation and significant risks. Suitability depends on age, fitness, donor options and disease features.

Ask which aim is being prioritised: easing symptoms, improving blood counts, reducing spleen-related discomfort or considering transplant. Keep a record of fever, breathlessness, bleeding, abdominal fullness, pain and changes in daily activity. Discuss medicines, vaccinations, dental care and infection precautions before treatment starts. Blood transfusions or medicines for anaemia may be considered when low counts cause symptoms. Read about [Targeted Therapy](/treatments/systemic-therapy/targeted-therapy/) and [Allogeneic Stem Cell Transplant](/treatments/cellular-and-transplant-therapy/allogeneic-stem-cell-transplant/).

Contact your care team promptly for a fever, new breathlessness, chest pain, unusual bleeding, black stools, severe weakness or rapidly worsening abdominal pain. Seek emergency care for severe breathing difficulty, fainting, confusion or bleeding that does not stop. These symptoms need assessment regardless of how stable the myelofibrosis has seemed.

What is the main goal of my proposed treatment? How will we monitor blood counts and spleen symptoms? Am I a candidate for transplant assessment, and what preparation would it involve? Which warning signs should prompt a same-day call?