How to Identify Myeloproliferative Neoplasms

Identifying Myeloproliferative Neoplasms (MPNs) can be a challenge. Many symptoms are general and correspond with a variety of other conditions that are not necessarily specific to MPNs. Some people have no symptoms while others can experience a variety of symptoms. 

Some people with MPNs have no symptoms at diagnosis and the symptoms can depend on the type of MPN the patient has. Several symptoms, such as itching, fatigue and difficulty sleeping, are shared by all three classic MPNs—Primary Myelofibrosis (MF), Essential Thrombocythemia (ET) and Polycythemia Vera (PV).

Some of the more common symptoms include:

  • Fatigue and tiredness
  • Shortness of breath during exertion
  • Pale skin
  • Loss of appetite
  • Weight loss
  • Bone pain
  • Night sweats
  • Itching
  • Infections and fever
  • Pain or a feeling of fullness below the ribs from an enlarged liver or spleen.
  • Weight loss without trying
  • Blood clots

There are also specific symptoms aligned with the three classic MPNs.

Primary Myelofibrosis Symptoms

In Primary Myelofibrosis, abnormal blood cells and fibers accumulate within the bone marrow, which causes the bone marrow to have difficulties making healthy blood cells. The liver and spleen try to make up the difference by producing blood cells. In its early stages, MF may not cause any symptoms, but as it progresses, it can cause symptoms such as:

 

  • Pain or a feeling of fullness below the left ribs (due to an enlarged spleen), which may make a person not eat as much.
  • Anemia (low red blood cells, or “RBCs”) can potentially cause symptoms of fatigue, dizziness, cold hands or feet or pale skin.
  • Neutropenia (low white blood cells, or “WBCs”) can cause repeated infections, or infections that won’t go away.
  • Thrombocytopenia (low platelets) can cause the body to bleed more easily, including frequent nosebleeds, bruising, or small, pinhead-sized red spots on the skin called petechiae.
  • Night sweats
  • Fever
  • Enlarged liver
  • Bone or joint pain
  • Weight loss

Essential Thrombocythemia Symptoms

A person with Essential Thrombocythemia (ET), has too many platelets (thrombocytes). Platelets are responsible for clotting, which is important when there is an injury to the body, but too many platelets can cause the blood to form clots within blood vessels, which may cause damage to organs. Some people have no symptoms from ET, but ET can cause symptoms such as:

 

  • Headaches
  • Burning or tingling pain in the hands or feet
  • Redness or warmth of hands or feet
  • Vision problems
  • Hearing problems

 

Polycythemia Vera Symptoms

In Polycythemia Vera, there are too many RBCs in the blood. The number of WBCs and platelets may also be high, and the excess blood cells can enlarge the spleen and cause the blood to be thick and prone to clot. Polycythemia Vera may be discovered on a blood test before there are symptoms. When symptoms occur from PV, they can include:

 

  • Headaches
  • Pain or a feeling of fullness below the left ribs (due to an enlarged spleen)
  • Changes to vision (double vision or seeing blind spots)
  • Itching, particularly after warm baths or showers
  • Reddened face
  • Fatigue or weakness
  • Dizziness
  • Unexplained weight loss

How are MPNs diagnosed?

Doctors usually discover MPNs when doing routine blood work or when evaluating patients with some of the symptoms listed above.There are several tests and tools doctors use to confirm a diagnosis including:

  • Physical exam and history.
  • A complete blood count with a differential that looks at the total number and type of blood cells in your blood.
  • A blood smear that allows your doctor to look at your blood under a microscope.
  • Bone marrow examination including aspiration and biopsy to see how your bone marrow looks (required for diagnosis).
  • Cytogenetic testing, which looks at abnormalities in your cell DNA.


If you are diagnosed with an MPN It’s important to continue working with a physician to identify worsening symptoms and monitor therapies.

Visit the MPN Research Foundation to learn more about recognizing symptoms and finding support.

 

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