NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

42 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 Part 5 is a treatment guide for myelofibrosis (MF, for short). It starts with describing how MF is found. Part 5 also explains the treatment process and options. Your doctor may suggest other options based on your health and wishes. Fully discuss your options with your doctor. Diagnosis MF ( m yelo f ibrosis) can occur in people without a history of bone marrow problems. This is called PMF ( p rimary m yelo f ibrosis). However, MF can also develop in people who have either ET or PV. This disease is respectively called post-ET myelofibrosis and post-PV myelofibrosis. Primary myelofibrosis PMF is often found because of symptoms. The most common symptom is severe fatigue. Another common symptom is quickly feeling full when eating. You may have discomfort under your ribs on the left side. Other symptoms include losing weight without trying, low fever, bone pain, and night sweats. PMF is also found because of tests given for other reasons. Your doctor may detect that your liver or spleen is big. See Figure 10 . Your blood results may be abnormal. More testing reveals PMF. There are two stages of PMF. One stage is called prePMF ( pre fibrotic PMF ) or early PMF. The other stage is called overt PMF. These stages were created to help tell prePMF apart from ET. Each stage is diagnosed based on certain standards. Prefibrotic PMF Your bone marrow must contain many abnormal platelet-forming cells (megakaryocytes). Other types 5 Myelofibrosis Diagnosis Figure 10 Spleen The spleen is a small organ to the left of your stomach. It is part of your immune system. As scar tissue replaces bone marrow, the number of your blood cells will drop. As a result, your spleen may begin to make blood cells and enlarge. An enlarged spleen is a common symptom of MF. Your liver may enlarge, too.