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</div><div><span>Myelofibrosis</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Myelofibrosis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Myelofibrosis is a disorder of the bone marrow in which the marrow is replaced by fibrous scar tissue.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Bone marrow is the soft, fatty tissue inside your bones. Stem cells are immature cells in the bone marrow that develop into all of your blood cells. Your blood is made of:</p><ul><li>Red blood cells (which carry oxygen to your tissues)</li><li>White blood cells (which fight infection)</li><li>Platelets (which help your blood clot) </li></ul><p>When the bone marrow is scarred, it cannot make enough blood cells. <a test="test" href="./000560.htm">Anemia</a>, bleeding problems, and a higher risk for infections may occur.</p><p>As a result, the liver and spleen try to make some of these blood cells. This causes these organs to swell.</p><p>The cause of myelofibrosis is often unknown. There are no known risk factors. When it occurs, it often develops slowly in people over age 50. Women and men are equally affected. There is an increased occurrence of this condition in Ashkenazi Jews.</p><p>Blood and bone marrow cancers, such as <a test="test" href="./007716.htm">myelodysplastic syndrome</a>, <a test="test" href="./001299.htm">leukemia</a>, and lymphoma, may also cause bone marrow scarring. This is called secondary myelofibrosis.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms may include any of the following:</p><ul><li><a test="test" href="./003124.htm">Abdominal fullness</a>, pain, or feeling full before finishing a meal (because of an enlarged spleen)</li><li><a test="test" href="./003180.htm">Bone pain</a></li><li>
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Easy bleeding, <a test="test" href="./003235.htm">bruising</a></li><li><a test="test" href="./003088.htm">Fatigue</a></li><li>Increased likelihood of getting an infection</li><li><a test="test" href="./003244.htm">Pale skin</a></li><li><a test="test" href="./003075.htm">Shortness of breath</a> with exercise </li><li><a test="test" href="./003107.htm">Weight loss</a></li><li>Night sweats</li><li>Low grade fever</li><li>Enlarged liver</li><li>Dry cough</li><li>Itchy skin</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical exam and ask about your symptoms.</p><p>Tests that may be done include:</p><ul><li><a test="test" href="./003642.htm">Complete blood count</a> (CBC) with blood smear to check different types of blood cells</li><li>Measuring tissue damage (<a test="test" href="./003499.htm">LDH enzyme level</a>)</li><li>Molecular testing </li><li><a test="test" href="./003934.htm">Bone marrow biopsy</a> to diagnose the condition and to check for bone marrow cancers </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p><a test="test" href="./003009.htm">Bone marrow or stem cell transplant</a> may improve symptoms, and may cure the disease. This treatment is usually considered for younger people.</p><p>Other treatment may involve:</p><ul><li><a test="test" href="./000431.htm">Blood transfusions</a> and medicines to correct anemia</li><li><a test="test" href="./001918.htm">Radiation</a> and <a test="test" href="./002324.htm">chemotherapy</a></li><li><a test="test" href="../patientinstructions/000902.htm">Targeted medicines</a></li><li>
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Removal of the spleen (<a test="test" href="./002944.htm">splenectomy</a>) if swelling causes symptoms, or to help with anemia </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>As the disease worsens, the bone marrow slowly stops working. Low platelet count leads to easy bleeding. Spleen swelling may get worse along with anemia.</p><p>The average survival of people with primary myelofibrosis is about 5 years. But some people survive for decades.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Development of <a test="test" href="./000542.htm">acute myelogenous leukemia</a></li><li>Infections</li><li>Bleeding</li><li>Blood clots</li><li>Liver failure </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Make an appointment with your provider if you have symptoms of this disorder. Seek medical care right away for uncontrolled bleeding, shortness of breath, or <a test="test" href="./000210.htm">jaundice</a> (yellow skin and whites of the eyes) that gets worse.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Idiopathic myelofibrosis; Myeloid metaplasia; Agnogenic myeloid metaplasia; Primary myelofibrosis; Secondary myelofibrosis; Bone marrow - myelofibrosis</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Gotlib J. Polycythemia vera, essential thrombocythemia, and primary myelofibrosis. In: Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine</em>. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 157.</p><p>Venugopal S, Najfeld V, Keyzner A, Jamal SME, Ronald H, Mascarenhas J. Primary myelofibrosis and chronic neutrophilic leukemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. <em>Hematology: Basic Principles and Practice</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 70.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 6/17/2024</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
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