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Primary myelofibrosis


Información en español Title


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Other Names:
Idiopathic myelofibrosis; Myeloid metaplasia; Agnogenic myeloid metaplasia
Categories:
Blood Diseases; Rare Cancers
This disease is grouped under:
Chronic myeloproliferative disorders

Summary Summary


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Primary myelofibrosis is a condition characterized by the buildup of scar tissue (fibrosis) in the spongy tissue tissue inside the bone (bone marrow), the tissue that contains the stem cells that will produce blood cells. Because of the fibrosis, the bone marrow is unable to make enough normal blood cells. In myelofibrosis, the bone marrow is replaced by fibrous (scar) tissue.[1][2]  When the bone marrow is scarred, it cannot make enough blood cells. This leads to anemia, weakness, fatigue, and often, swelling of the liver and spleen.[1][3] The disorder occurs when blood stem cells develop somatic mutations in the JAK2, MPL, CALR, and TET2 genes. Other genes may also be involved. The disorder is generally not inherited because this type of mutation does not affect the reproductive cells (sperm and egg) only certain cells of the body (somatic).[2] Although myelofibrosis can occur at any age, it typically develops after the age of 50 years.[1][3] In most cases, myelofibrosis gets progressively worse. Treatment is aimed at relieving signs and symptoms and may include medications, blood transfusions, chemotherapy, radiation therapy, and surgery.[3] Bone marrow or stem cell transplant may improve symptoms, and may cure the disease.[1]   
Last updated: 6/13/2017

Symptoms Symptoms


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This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 33 |
Medical Terms Other Names
Learn More:
HPO ID
30%-79% of people have these symptoms
Abnormal megakaryocyte morphology 0012143
Anemia
Low number of red blood cells or hemoglobin
0001903
Fatigue
Tired
Tiredness
[ more ]
0012378
Hepatomegaly
Enlarged liver
0002240
Hepatosplenomegaly
Enlarged liver and spleen
0001433
Pallor 0000980
Splenomegaly
Increased spleen size
0001744
Thrombocytopenia
Low platelet count
0001873
5%-29% of people have these symptoms
Anorexia 0002039
Arterial thrombosis
Blood clot in artery
0004420
Bone marrow hypercellularity 0031020
Easy fatigability 0003388
Ecchymosis 0031364
Extramedullary hematopoiesis 0001978
Flank pain 0030157
Leukocytosis
Elevated white blood count
High white blood count
Increased blood leukocyte number
[ more ]
0001974
Low-grade fever
Mild fever
0011134
Lymphadenopathy
Swollen lymph nodes
0002716
Pancytopenia
Low blood cell count
0001876
Petechiae 0000967
Poikilocytosis 0004447
Portal hypertension 0001409
Thrombocytosis
Increased number of platelets in blood
0001894
Venous thrombosis
Blood clot in vein
0004936
1%-4% of people have these symptoms
Cachexia
Wasting syndrome
0004326
Hemangioma
Strawberry mark
0001028
Hematological neoplasm 0004377
Increased lactate dehydrogenase level 0025435
Percent of people who have these symptoms is not available through HPO
Fever 0001945
Myelofibrosis 0011974
Myeloproliferative disorder 0005547
Purpura
Red or purple spots on the skin
0000979
Somatic mutation 0001428
Showing of 33 |
Do you have more information about symptoms of this disease? We want to hear from you.
Last updated: 1/1/2021

Diagnosis Diagnosis


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Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources

  • The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.

Treatment Treatment


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The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional.

Management Guidelines

  • The NORD Physician Guide for Primary myelofibrosis was developed as a free service of the National Organization for Rare Disorders (NORD) and it's medical advisors.  The guides provide a resource for clinicians about specific rare disorders to facilitate diagnosis and treatment of their patients with this condition. 

FDA-Approved Treatments

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products.

  • Ruxolitinib Phosphate (Brand name: Jakafi) - Manufactured by Incyte Corporation
    FDA-approved indication: Treatment of patients with intermediate or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis and post-essential thrombocythemia myelofibrosis. Treatment of patients with polycythemia vera who have had an inadequate response to or are intolerant of hydroxyurea.
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information

Statistics Statistics


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Few epidemiologic studies are available to estimate the occurrence of myelofibrosis.[4] Through the review of several medical textbooks and journal articles, it appears as if the annual incidence (occurrence) in European, Australian, and North American populations ranges from 0.3 to 1.5 cases per 100,000 persons.[4][5][6][7][8]
Last updated: 6/22/2016
Do you have updated information on this disease? We want to hear from you.

Find a Specialist Find a Specialist


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If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

  • To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.

Related Diseases Related Diseases


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Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnosis of PMF includes other closely related myeloid neoplasms, such as chronic myeloid leukemia, essential thrombocythemia, polycythemia vera, myelodysplastic syndromes, chronic myelomonocytic leukemia, acute panmyelosis with myelofibrosis and acute megakaryoblastic leukemia.
Visit the Orphanet disease page for more information.

Research Research


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Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Primary myelofibrosis. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Organizations Organizations


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Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

  • Leukemia and Lymphoma Society
    3 International Drive, Suite 200
    Rye Brook, NY 10573
    Toll-free: 1-(800) 955-4572 (patients and families)
    Telephone: 1-(888) 557-7177 (general)
    E-mail: https://www.lls.org/content/contact-us
    Website: https://www.lls.org/
  • MPN Research Foundation
    180 N. Michigan Avenue
    Suite 1870
    Chicago, IL 60601
    Toll-free: +1-855-258-1943 (Support)
    Telephone: +1-312-683-7249
    Fax: +1-312-332-0840
    E-mail: rrosen@MPNResearchFoundation.org
    Website: http://www.mpnresearchfoundation.org/

Social Networking Websites

  • MPD-Support: Myeloproliferative Diseases Support and Daily E-mail Digest
Do you know of an organization? We want to hear from you.

Living With Living With


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Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Financial Resources

  • Good Days provides help to patients with life-altering conditions. Assistance includes help with the cost of medications and travel.
  • Patient Access Network Foundation (PAN Foundation) has Assistance Programs for those with health insurance who reside in the United States. The disease fund status can change over time, so you may need to check back if funds are not currently available. 

Learn More Learn More


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These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • MayoClinic.com offers additional information about myelofibrosis. Click on the above link to access this information.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • MedlinePlus Genetics contains information on Primary myelofibrosis. This website is maintained by the National Library of Medicine.
  • The MPN Education Foundation provides information on Primary myelofibrosis.
  • The Leukemia & Lymphoma Society has an article on idiopathic myelofibrosis. Click on Leukemia & Lymphoma Society to view the article.
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Primary myelofibrosis. Click on the link to view a sample search on this topic.

GARD Answers GARD Answers


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Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • I need to ascertain the incidence of myelofibrosis in the United States. Is myelofibrosis considered to be a rare disorder? See answer


Have a question? Contact a GARD Information Specialist.

References References


  1. Chen YB. Myelofibrosis. MedlinePlus. May 29, 2014; http://www.nlm.nih.gov/medlineplus/ency/article/000531.htm.
  2. Primary myelofibrosis. Genetics Home Reference (GHR). September 2014; https://ghr.nlm.nih.gov/condition/primary-myelofibrosis.
  3. Myelofibrosis. MayoClinic.com. August 1, 2014; https://www.mayoclinic.org/diseases-conditions/myelofibrosis/symptoms-causes/syc-20355057.
  4. Hoffman R, Ravandi-Kashani F. Chapter 70 - Idiopathic Myelofibrosis. Hematology: Basic Principles and Practice, 4th edition. Philadelphia, PA: Elsevier; 2005;
  5. Tefferi, A. Chapter 177 - Myeloproliferative Disorders: Essential Thrombocytopenia and Primary Myelofibrosis. Cecil Medicine, 23rd edition. Philadelphia, PA: Elsevier; 2007;
  6. Tefferi A. Chapter 106- Myeloproliferative Disorders. Abeloff's Clinical Oncology, 4th edition. Philadelphia, PA: Elsevier; 2008;
  7. Mehta J, Wang H, Iqbal SU, Mesa R.. Epidemiology of myeloproliferative neoplasms in the United States. Leuk. Lymphoma. March 1, 2014; 55(3):595-600. http://www.ncbi.nlm.nih.gov/pubmed/23768070.
  8. Moulard O, Mehta J, Fryzek J, Olivares R, Iqbal U, Mesa RA.. Epidemiology of myelofibrosis, essential thrombocythemia, and polycythemia vera in the European Union. Eur. J. Haematol.. April 1, 2014; 92(4):289-297. http://www.ncbi.nlm.nih.gov/pubmed/24372927.
Do you know of a review article? We want to hear from you.
You can help advance
rare disease research!
You can help advance rare disease research!
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