Myelofibrosis symptoms
Fact-checked by There are several possible symptoms of myelofibrosis, many of which overlap with those of other blood cancers.
In myelofibrosis, the bone marrow produces large amounts of abnormal blood cells that don’t work properly. These cells release inflammatory molecules that eventually cause bone marrow scarring (fibrosis), further inhibiting the production of healthy blood cells. The spleen, trying to compensate by making more blood cells, becomes enlarged.
Most of its common symptoms are direct consequences of these processes, but the exact signs of myelofibrosis will vary from person to person, depending on what is happening in the bone marrow.
Some people may be diagnosed at an early stage, where blood cell counts are high and symptoms are minimal or absent. Others are diagnosed when the disease has already caused major issues in the bone marrow, leading to more severe complications.
Common symptoms
For many people, myelofibrosis progresses slowly and may not cause symptoms for many years. Consequently, the early signs of myelofibrosis can be subtle.
When symptoms do become obvious, they’re usually related to one of three issues: low blood cell counts, spleen enlargement, or chronic inflammation.
Symptoms related to abnormal blood cell counts
In myelofibrosis, the bone marrow is crowded with blood cells that are immature or don’t work properly. The production of new healthy blood cells is impeded by inflammation and scarring. This leads to common myelofibrosis symptoms including:
- fatigue or weakness
- shortness of breath or dizziness
- easy bruising and bleeding
- frequent infections
Myelofibrosis fatigue, weakness, and shortness of breath arise due to anemia, or a lack of healthy red blood cells that are responsible for carrying oxygen through the body.
A lack of healthy platelets, the cell fragments that help blood clot, leads to easy bruising and unusual bleeding. Sometimes, especially in earlier disease stages, platelet counts might be too high, which can cause blood clotting complications.
White blood cells include immune cells that help the body fight infections. Abnormalities in these cells increase a person’s susceptibility to infections, which can be severe.
Constitutional symptoms
Myelofibrosis also commonly leads to a range of systemic, or constitutional, symptoms that overlap with those of other types of blood cancer. These symptoms are generally related to high inflammation in the body.
Constitutional symptoms of myelofibrosis include:
- drenching night sweats
- unexplained fever
- itchy skin
- bone and joint pain
- unexplained weight loss
- extreme fatigue
- problems with concentration or cognition
Symptoms caused by an enlarged spleen
Most people with myelofibrosis will also develop splenomegaly, or an enlarged spleen. The spleen stores and filters blood, and helps make immune cells and antibodies to fight infection.
When the bone marrow starts failing to produce healthy blood cells in myelofibrosis, the spleen boosts production of these cells to help out. This causes the organ to expand and put pressure on surrounding abdominal organs, leading to symptoms such as:
- feeling full after consuming only a little food, leading to malnutrition and weight loss
- abdominal pain and fullness
- nausea or other digestive problems
Other symptoms and complications
Other possible symptoms and complications of myelofibrosis include:
- gouty arthritis, a painful inflammatory joint condition
- extramedullary hematopoiesis, or production of blood cells in tissues outside the bone marrow
- serious blood clotting complications, such as a heart attack or stroke
- severe bleeding
- conversion to leukemia
Gouty arthritis occurs because high blood cell turnover leads to the buildup of a waste product called uric acid in joints.
While the spleen is the main site of extramedullary hematopoiesis, other organs may also start to produce blood cells, particularly the liver. An enlarged liver may cause symptoms such as upper right abdominal pain or fullness, nausea, or vomiting.
Enlargement in the liver and spleen can also contribute to portal hypertension, a serious complication characterized by elevated pressure in the liver’s major blood vessel. Portal hypertension signs include abdominal swelling, vomiting blood, and confusion.
Extramedullary hematopoiesis may also cause enlargements or masses elsewhere in the body, impairing the function of other organs or tissues.
About 10%-20% of people with myelofibrosis will develop acute myeloid leukemia, a more aggressive type of blood cancer.
When to call your doctor
Certain myelofibrosis complications are medical emergencies that can be life-threatening if not managed promptly. Individuals should seek immediate medical care if they experience any of the following:
- signs of blood clots, including slurred speech, one-sided weakness, chest pain or sudden shortness of breath, throbbing pain, redness, or swelling in a leg or arm
- severe or uncontrollable bleeding, including vomiting or defecating blood
- signs of a serious infection, including high fever, severe weakness, rash, or blisters
- severe or rapid abdominal pain or swelling, which could be complications of spleen or liver enlargement or rupture
Individuals should always talk to their healthcare team about what to expect with their myelofibrosis and its treatment, and what to do when concerning symptoms arise.
Myelofibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
