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Complications
By Mayo Clinic staffComplications that may result from myelofibrosis include:
- Increased pressure on blood flowing into your liver. Normally, blood flow from the spleen enters your liver through a large blood vessel called the portal vein. Increased blood flow from an enlarged spleen can lead to high blood pressure in the portal vein (portal hypertension). This in turn can force excess blood into smaller veins in your stomach and esophagus, potentially causing these veins to rupture and bleed. If problems develop, your doctor may recommend removal of your spleen.
- Pain in your upper left side or shoulder. This may result from episodes of inflammation or tissue death in your spleen. Pain relievers can usually help control symptoms.
- Other organ involvement. Formation of blood cells outside the bone marrow (extramedullary hematopoiesis) may create clumps (tumors) of developing blood cells in other areas of your body. These tumors may cause problems such as bleeding in your gastrointestinal system, coughing or spitting up of blood, compression of your spinal cord, or seizures. Extramedullary blood formation is usually treated with low-dose radiation.
- Infections. Myelofibrosis can cause the overproduction of white blood cells, which help fight infection. But in myelofibrosis, these blood cells often aren't fully formed or are mutated so that they become ineffective, actually decreasing your ability to fight off infections.
- Bleeding complications. As the disease progresses, platelet count tends to drop below normal (thrombocytopenia) and platelet function becomes impaired. An insufficient number of platelets can lead to easy bleeding — an issue that you and your doctor will want to discuss if you're contemplating any type of surgical procedure.
- Hardening and inflammation of bone tissue. Myelofibrosis can lead to hardening of your bone marrow as well as inflammation of the connective tissue that surrounds your bones, leading to severe bone and joint pain and tenderness.
- Gout. Myelofibrosis increases your body's production of uric acid, a byproduct of the breakdown of purines — a substance found naturally in your body and in many foods. Overproduction of uric acid can lead to needle-like deposits of the substance in your joints, causing joint pain and inflammation (gout). You may need medications to keep your levels of uric acid normal.
- Acute leukemia. Some people with myelofibrosis eventually develop acute myelogenous leukemia, a type of blood and bone marrow cancer that progresses rapidly.
References
- Tefferi A. Clinical manifestations and diagnosis of primary myelofibrosis (agnogenic myeloid metaplasia). http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
- Tefferi A. Prognosis and treatment of primary myelofibrosis (agnogenic myeloid metaplasia). http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
- Tefferi A. Pathogenic mechanisms in primary myelofibrosis (anogenic myeloid metaplasia). http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
- Cervantes F. Modern management of myelofibrosis. British Journal of Haemotology. 2005;128(5):583-92.
- Papageorgiou SG, et al. Allogeneic stem cell transplantation as treatment for myelofibrosis. Bone Marrow Transplant. 2006;38(11):721-727.
- Idiopathic myelofibrosis. Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/attachments/National/br_1190656475.pdf. Accessed Oct. 14, 2008.
- Chronic idiopathic myelofibrosis. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/myeloproliferative/HealthProfessional/page5. Accessed Oct. 14, 2008.
- Myelofibrosis with myeloid metaplasia. MayoClinic.org. http://www.mayoclinic.org/myelofibrosis/treatment.html. Accessed Oct. 14, 2008.
- Reduced-intensity transplants. National Marrow Donor Program. http://www.marrow.org/PATIENT/Undrstnd_Disease_Treat/Undrstnd_Treat_Opt/Lrn_BMT_Cord/R_Intensity_Tx/index.html. Accessed Oct. 14, 2008.
