Myeloproliferative Neoplasm

Essential Thrombocythemia is a rare blood disorder that occurs when abnormal stem cells in your bone marrow make too many platelets (the blood cells that control bleeding). Essential thrombocythemia increases the chance for excessive bleeding and blood clotting, which may block your blood flow. Clots can develop anywhere in the body, including the brain, hands and feet. Clotting puts you at an increased risk for heart attack or stroke. So, it’s important to develop a close relationship with your doctor who can help you manage your condition.

Essential Thrombocythemia symptoms

You may not have any symptoms, but could experience:

• Headache
• Dizziness
• Shortness of breath
• Burning in the palms of the hands or soles of the feet
• Redness in the palms of the hands and soles of the feet
• Bruising and bleeding.

Essential Thrombocythemia treatment

To diagnose your condition, you may undergo a complete blood count (CBC) to measure your blood cell levels, following a bone marrow aspiration and biopsy. Your personalized treatment plan will be based on your lab results, symptoms and age. Treatment may include medications to prevent blood clots and lower platelet levels. Our team will work closely with you to determine a treatment that provides the best results to meet your goals. Medications could include:

• Aspirin to prevent blood clots
• Hydroxyurea (Hydrea®), an oral chemotherapeutic drug that lowers platelet levels
• Anagrelide (Agrylin®), which slows platelet production from the bone marrow and may be used for patients who are not benefiting from hydroxyurea
• Interferon alfa (Multiferon®), used to stimulate the body’s immune system to fight the cancerous cells
• Busulfan (Myleran®), an oral chemotherapeutic drug that lowers platelet levels and may be used for patients who are not benefiting from hydroxyurea
• Systemic anti-coagulation, which may be used for patients who are at higher risk of blood clots and/or for those who have a personal history of blood clots
• Ruxolitinib (Jakafi®), one of the first targeted therapies for this disease, may be used to treat patients who are experiencing frequent symptoms or who have an enlarged spleen

Primary myelofibrosis is a rare form of bone marrow cancer that affects the stem cells responsible for producing healthy blood cells. The abnormal cells cause fibrous tissue to grow in your bone marrow.

Myelofibrosis symptoms

Typical myelofibrosis symptoms may include:

• Fatigue and weakness
• Anemia
• Easy bruising and bleeding
• Night sweats
• Weight loss
• Abdominal discomfort or a feeling of fullness from an enlarged spleen, which may increase your risk of infection

Myelofibrosis Treatment

To determine your diagnosis and develop an individualized care plan, you may undergo a combination of laboratory tests including blood tests, imaging tests such as MRI, and a bone marrow biopsy.

Your hematology care team will work with you to create a myelofibrosis treatment based on the severity of your condition and your individual needs and preferences. Myelofibrosis treatment options may change over time as your condition progresses and as new treatments become available. Your hematology care team will work closely with you to ensure you are receiving appropriate treatment as your condition changes over time. Common treatments for myelofibrosis include:

• Blood Transfusions to replace the missing red blood cells and alleviate fatigue and weakness associated with anemia.
• Platelet Transfusions to help prevent bleeding.
• Iron Chelation Therapy, which removes excess iron from the body.
• JAK Inhibitors, a new class of drugs developed specifically for myelofibrosis that block the signals that drive the abnormal growth of blood cells.
• Stem Cell Transplant, for severe cases of myelofibrosis. It involves replacing the damaged hematopoietic stem cells in the bone marrow with healthy ones.
• Supportive Care to help manage the symptoms of myelofibrosis may include pain management, treatment for infections, and measures to reduce the risk of bleeding.

Polycythemia vera (PV) blood disorder is the most common form of myeloproliferative neoplasms. It occurs when there are too many red blood cells made in the bone marrow. Many times, the change in your blood cells is discovered from routine blood tests requested by your primary care physician. Polycythemia vera is diagnosed from blood tests or by a bone marrow biopsy performed by your hematologist.

Polycythemia Vera symptoms

Polycythemia vera develops slowly and symptoms may not develop for years, but could include:

• Headache
• Dizziness
• Itching or pain of the skin
• Abdominal fullness
• Blood clots or bleeding

Polycythemia Vera treatment

Polycythemia vera treatment focuses on preventing complications, such as blood clots. We also focus on addressing your symptoms, such as itchy or painful skin, or abdominal discomfort from a large spleen. At Novant Health Cancer Institute, your hematologist will work closely with you to develop a personalized plan.

• Aspirin to prevent blood clots and phlebotomy (a procedure to remove the right amount of blood to lower hemoglobin and hematocrit)
• Hydroxyurea (Hydrea®), an oral chemotherapeutic drug that lowers platelet levels
• Interferon alfa (Multiferon®), used to stimulate the body’s immune system to fight the cancerous cells
• Busulfan (Myleran®), an oral chemotherapeutic drug that lowers platelet levels and may be used for patients who are not benefiting from hydroxyurea
• Ruxolitinib (Jakafi®), one of the first targeted therapies for this disease, may be used to treat patients who are experiencing frequent symptoms or who have an enlarged spleen

Chronic myeloid leukemia (CML) is a chronic bone marrow and blood cancer that can be managed with treatment. Once a life-threatening disease, the introduction of TKI therapy in 2001 has transformed chronic myeloid leukemia to a manageable chronic condition. People with chronic myeloid leukemia are living longer and experiencing fewer treatment side effects.

Chronic myeloid leukemia is diagnosed from a simple blood test. You may also undergo a bone marrow biopsy to help define the phase of your condition. This enables your care team to provide the best treatment plan for you.

Chronic myeloid leukemia treatment

Chronic myeloid leukemia is a chronic condition that typically can be successfully controlled for the duration of your natural life through oral medicines. The primary treatment for chronic myeloid leukemia is a daily oral drug therapy called tyrosine kinase inhibitor (TKI) therapy. TKI therapy offers a way to manage this chronic condition, even providing a cure for some people.

There are six different TKIs and the best treatment for you depends on your lab results and previous health conditions. Your care team will regularly check your blood work and adjust your medicine as needed.