Myeloproliferative disorders are a group of cancers characterized by the uncontrolled replication of cells derived from myeloid stem cells. These cells have the potential to become red blood cells, platelets, and some types of white blood cells.
The term “myeloproliferative disorders” was created in
The four most common types of myeloproliferative disorders are:
Read on to learn more about these conditions, including symptoms, treatment options, and outlook.
Your bone marrow contains blood stem cells that have the potential to become two other types of stem cells called myeloid and
Myeloid stem cells have the potential to become red blood cells, platelets, and some type of white blood cells. Lymphoid stem cells become different types of white blood cells.
Myeloproliferative disorders are a group of cancers that develop in cells derived from myeloid stem cells. There are
- Chronic myeloid leukemia (CML). CML is a slow-growing leukemia that starts in immature myeloid cells. About
1 in 526 people in the United States will develop CML in their lifetime. - Primary myelofibrosis. Primary myelofibrosis is a condition where bone marrow is replaced with a scar-like material that leads to the abnormal production of blood cells. The condition is estimated to develop in 1.5 people per 100,000 per year in the United States.
- Essential thrombocythemia. Essential or primary thrombocythemia is a condition where your body produces too many platelets, the cells that help your blood clot. It’s estimated to affect
0.2 to 2.5 people per 100,000 per year. - Polycythemia vera. Polycythemia vera is a condition that causes your body to produce an excessive number of red blood cells, which thicken your blood. It’s estimated to affect 2.8 men per 100,000 and 1.3 per 100,000 women per year.
Rarer types of myeloproliferative disorders include:
- Chronic neutrophilic leukemia (CNL). CNL is an extremely rare condition characterized by the overproduction of white blood cells called neutrophils.
- Chronic eosinophilic leukemia (CEL). Chronic eosinophilic leukemia is a rare leukemia where your body overproduces white blood cells called eosinophils, which release chemicals in response to infections and allergies. CEL usually progresses slowly. Less commonly, it changes into an aggressive leukemia called acute myeloid leukemia (AML).
Symptoms vary depending on what type of myeloproliferative disorder you have. It’s common not to have any symptoms in the early stages of the disease.
Here’s a look at some potential symptoms for the
CML
Polycythemia vera
- thickened blood that increases risk of blood clots
- headaches
- dizziness
- visual problems
- itchy skin
- general feeling of unwellness
- tinnitus
- burning or prickling in limbs
- aquagenic pruritus, (itching or stinging after a warm bath or shower)
- erythromelalgia (burning pain and redness most commonly in feet)
- abdominal pain
- loss of appetite
- weight loss
- liver and spleen enlargement
- facial swelling
- gout
- high blood pressure
Essential thrombocythemia
- headache
- dizziness
- visual changes
- burning or prickling in limbs
- fatigue
- easy bruising
- stroke-like symptoms
- enlarged spleen
Primary myelofibrosis
- fatigue
- night sweats
- low grade fever
- poor appetite
- weight loss
- abdominal fullness or pain
- painful urination
- blood in urine
- gastrointestinal bleeding
- joint stiffness
- bone pain
- paleness
- petechiae (pinpoint red spots on skin)
- enlarged spleen or liver
- enlarged lymph nodes
- pleural and pericardial effusion (water in lungs or around heart)
- pulmonary edema
- seizure
- altered mental status
- spinal cord compression
Myeloproliferative disorders are caused by the overproduction of blood cells, but the exact reason they occur isn’t known. They tend to develop in
People with a
The diagnostic process for myeloproliferative disorders starts by contacting a healthcare professional and scheduling an appointment. They will perform a physical exam and evaluate your medical and family history.
If they suspect a blood disorder, they’ll likely order blood tests. Many
- complete blood count
blood smear - comprehensive metabolic panel
- electrolyte test
- uric acid test
- lactate dehydrogenase test
- genetic testing for AK2, MPL, CALR, and CSF3R mutations.
A definitive diagnosis is usually made with a bone aspiration and biopsy. During this procedure, a doctor uses a long and thin needle to take a sample of your bone marrow for lab analysis.
Allogeneic stem cell transplantation remains the
CML
The main CML treatment is a medication called imatinib. It reduces the production of abnormal white blood cells. If it is not effective, you may be offered similar medications like:
Chemotherapy with or without an allogeneic stem cell transplant may be recommended if you cannot take these medications or you have advanced CML.
Polycythemia vera
Polycythemia vera treatment focuses on reducing the thrombosis risk and providing symptom relief.
People under 60 years old and who do not have a history of blood clots are considered to have a low risk of developing blood clots. Treating polycythemia vera in people at low risk can include:
- watchful waiting
- low dose aspirin
- phlebotomy, a procedure where extra red blood cells are removed with a needle
People at high risk may also take medications to reduce blood cell count.
Essential thrombocythemia
Essential thrombocythemia is usually treated with watchful waiting or low doses of aspirin. People at high risk may also receive medications to lower their blood cell count.
Primary myelofibrosis
People without symptoms are generally not treated. People with symptoms may be treated with the following medications:
They may also be treated with an allogeneic stem cell transplant
Your outlook depends on factors such as:
- the type of myeloproliferative disorder you have
- how progressed the condition is
- your overall health
- your age
The outlook for CML has improved in recent years with the development of new medications.
According to the National Health Service, it’s estimated that more than 70% of men and 75% of women with CML live at least 5 years following their diagnosis. One large study found that post-diagnosis, about
In a
- half of people with primary myelofibrosis lived 5.9 years
- half of people with polycythemia vera lived at least 13.5 years
- half of people with essential thrombocythemia lived 19.8 years.
Myeloproliferative neoplasms are a group of cancers that cause the overproduction of cells that become red blood cells, platelets, and some types of white blood cells.
Symptoms, treatment options, and outlook depend on which specific condition you have.
If you’re diagnosed with a myeloproliferative neoplasm, your doctor can recommend the best treatment option. If your condition is in the early stages, they may recommend simply waiting to see how it develops.