Myelofibrosis (MF) is a bone marrow cancer that affects your blood and cell production. Over time, MF can lead to complications such as portal hypertension, tumors, and the development of acute leukemia.

Myelofibrosis (MF) is fairly rare, occurring in only about 4-6 people per 100,000 in the United States. It usually develops slowly over a long period of time.

Not everyone experiences symptoms, and the most common symptoms are often related to other, more common diseases.

Still, knowing the symptoms of MF can help you have a more informed discussion with your doctor about this disease. And, if you do receive a diagnosis of MF, you can get you started on a treatment plan as early as possible.

In the early stages of MF, many people do not experience symptoms. However, as the disease progresses and normal blood cell production in the body becomes more disrupted, you may begin to experience symptoms. These can include:

  • pale skin
  • easy bruising or bleeding
  • excessive sweating while sleeping
  • fever
  • frequent infections
  • fatigue, feeling weak, or feeling short of breath (usually
    caused by anemia)
  • bone pain
  • pain or a feeling of fullness below your ribs, usually on
    the left side (caused by an enlarged spleen)

When should you contact a doctor?

If you’re experiencing symptoms like easy bruising or bleeding, excessive sweating while sleeping, fevers, or fatigue for an extended period of time, contact a doctor. In addition to discussing symptoms you’ve been having, they’ll perform a physical exam and may order blood and imaging tests, and possibly a bone marrow exam.

If your doctor thinks you may have MF, they’ll likely refer you to a hematologist, a doctor who specializes in blood and bone marrow disorders.

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As MF progresses, you may have more severe symptoms. As bone marrow continues to turn to scar tissue and blood cell production becomes more abnormal, you also may begin to experience more serious side effects or complications, such as:

Abdominal and back pain

An enlarged spleen can cause abdominal and back pain. This can be a symptom of MF. Joint pain can also occur as bone marrow hardens and connective tissue around the joints becomes inflamed.

Excess uric acid which can cause gout-like joint pain and swelling

MF causes the body to produce more uric acid than normal. The increased uric acid can crystallize and settle around joints, causing sharp pain, inflammation, and swelling.

Increased blood flow to the liver which can raise blood pressure

Blood flows from the spleen into the liver to be processed. An enlarged spleen will cause the amount of blood flowing into the liver, and also the blood pressure, to increase. This is called portal hypertension.

The increased blood pressure can force extra blood into smaller veins in the digestive system, such as the esophagus or stomach. This could cause these smaller veins to rupture and bleed.

Easy bleeding

As MF progresses, your platelet count could drop below normal. A low number of platelets (thrombocytopenia) can lead to easy bleeding. If you’re considering a surgical procedure, this is an important complication for you and your doctor to consider.

Formation of blood cells outside the bone marrow

MF can lead to clumps or tumors of blood cells in other parts of the body, causing complications such as bleeding, nerve damage, or seizures.

Acute leukemia

About 12 percent of people with MF will develop acute myelogenous leukemia (AML). AML is a quickly progressing cancer of the blood and bone marrow.

The outlook for people with MF is different for every person who has the disease. Some people live for many years without developing worsening symptoms or complications. Others find that the disease and its complications progress more quickly.

Factors that can affect outlook include:

  • your age at the time of diagnosis
  • your white blood cell counts
  • the number of “blasts” (immature blood cells) in your blood
  • the number and severity of your symptoms, such as:
    • night sweats
    • weight loss
    • fever
    • anemia
    • transfusion dependence
    • abnormal chromosomes

It’s best to talk with your doctor about your individual outlook. They can take into account your health history and other factors affecting your prognosis.

Unlike other types of cancer, doctors don't use a staging system for myelofibrosis. Instead, they rely on symptom severity and how the cancer is responding to treatment to determine disease progression.

Some people eventually develop acute myelogenous leukemia (AML), which is a fast-growing type of blood and bone marrow cancer. In the United States, the 5-year survival rate for adults with AML is 29.5%.

What are the signs myelofibrosis is getting worse?

To determine disease progression, doctors may monitor your red and white blood cell counts, along with the number of blasts (immature white blood cells) that are circulating in your blood and bone marrow.

Having a low red blood cell count and very high white blood cell count can indicate disease progression. Symptoms you may feel as the disease progresses include fever and increased fatigue.

What is the life expectancy rate for myelofibrosis?

The median survival rate for a person with myelofibrosis is approximately 5 years. That means that the number of people who live less than 5 years is the same as those who live longer than 5 years.

It's worth noting that the outlook for people with myelofibrosis varies widely depending on individual risk factors, such as age, genetics, disease progression, and response to treatment.

What are the 4 hallmarks of myelofibrosis?

The 4 most common hallmarks or symptoms of myelofibrosis are:

  • enlarged spleen
  • anemia
  • bone marrow scarring
  • symptoms associated with the disease, such as:
    • pale skin
    • easy bruising or bleeding
    • excessive sweating while sleeping
    • fever

MF may not cause symptoms in its early stages, but it can lead to serious complications. Being aware of possible symptoms can help you have an informed discussion with your doctor, so MF is not mistaken for other conditions.

Symptoms to look for include:

  • pale skin
  • easy bruising or bleeding
  • excessive sweating while sleeping
  • fever
  • fatigue

See a doctor if you're experiencing any of these symptoms. Proactively visiting a doctor and getting a diagnosis can help you begin treatment early and hopefully avoid future complications.