What are the treatment options? So many people ask that question.  It depends on how the symptoms are progressiing. But here is a simplified site I found. You can go on to Mayo Clinic, site or google it but - here is this one.  This is from the Macmillian Cancer Support Site.  

Treatment

Treatment of myelofibrosis aims to control symptoms without causing too many side effects and will depend on how the disease is affecting you.  Your haematologist/oncologist will monitor your condition regularly. If you develop any symptoms between appointments, let your specialist know.

If you have symptoms caused by a low red blood cell count (anaemia), you can be given transfusions of blood. Usually it is possible to have a blood transfusion as a day patient, but it may involve an overnight stay in hospital. Blood transfusions can be repeated as often as necessary.

Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be used to treat myelofibrosis, especially if the symptoms are severe.

Chemotherapy can help to reduce the size of the spleen and the liver, and can help to control other symptoms. It may also help to increase the number of blood cells.

Chemotherapy is usually given as a tablet. A drug called hydroxycarbamide (Hydrea®)may be given, or you may sometimes be given low doses of another drug called melphalan (Alkeran®).

One of the side effects of chemotherapy is that it temporarily affects the way the bone marrow works. However, chemotherapy is often given in reduced doses to help lower the risk of serious side effects.

Chemotherapy isn't suitable for everyone with myelofibrosis. If you do have chemotherapy, you'll be monitored very closely.

Your doctor or nurse will explain which drugs you will have and possible side effects.

Other drugs

Some other drugs may be used to improve symptoms of myelofibrosis, but they're not suitable for everyone. Your specialist will tell you if they are appropriate in your situation.  

Thalidomide is a type of biological therapy that affects the way the immune system works. It's a newer treatment that may be used to treat myelofibrosis. Thalidomide is taken as a tablet. The side effects can include feeling sick, constipation and numbness or tingling of the hands and feet.

Danazol This drug may be given to help improve anaemia (low number of red blood cells).

Removing the spleen (splenectomy)

Your specialist may suggest that you have an operation to remove the spleen if you have a very low number of platelets, or if your spleen is enlarged and causing pain.

There can be advantages and disadvantages to having this operation. Your specialist will discuss these with you before you make a decision.

Radiotherapy

If it isn’t possible to remove the spleen, it may be possible to shrink an enlarged spleen using radiotherapy. Radiotherapy is the use of high-energy rays to destroy cancer cells while doing as little harm as possible to the healthy cells.

Radiotherapy can help to improve symptoms such as pain and a high platelet count. But the improvements in symptoms may only last for a few months.

Radiotherapy can cause side effects such as tiredness and skin irritation, although generally these are mild.

Stem cell transplant

A small number of younger people with myelofibrosis may be able to have high-dose chemotherapy followed by a stem cell transplant from a donor (allogeneic transplant). Usually, the donor is a brother or sister, but may occasionally be an unrelated donor.

This is very intensive treatment, so it is only suitable for younger, fitter people. The risks involved with a transplant increase as you get older.

Stem cells are early blood cells at their very earliest stage of development. They are collected from the donor's blood and then stored.

You will be given high doses of chemotherapy to destroy the cells in your bone marrow. Afterwards you'll be given the donor's stem cells as a transfusion. The stem cells will find their way through the bloodstream to the bone marrow, where they will start to grow and develop into mature blood cells.

Your specialist will discuss the possible benefits and risks of this treatment with you.

Clinical trialsBack to top

Research into new ways of treating myelofibrosis is ongoing. Clinical trials are looking at the use of drugs that affect the activity of the JAK2 gene (JAK2 inhibitors).

Your doctor may invite you to take part in a clinical trial to compare a new treatment against the best available standard treatment. Your doctor must discuss the treatment with you, and have your informed consent before entering you into a trial.

Before any trial is allowed to take place, it must be approved by a research ethics committee, which protects the interests of those taking part.

You may decide not to take part, or to withdraw from the trial at any stage. You will then receive the best standard treatment available.

Follow-upBack to top

You will need to have regular check-ups and blood tests. These will probably be ongoing. If you have any problems or notice any new symptoms in between these times, let your nurse or doctor know as soon as possible.

Information and supportBack to top

Everyone has their own way of dealing with their illness and the different emotions they experience. Some people find it helpful to talk things over with family and friends or their doctor or nurse. You can also contact our cancer support specialists or the other support organisation listed below for more information and support.

Useful organisationsBack to top

MPD Voice
Guy's and St Thomas' Charity
Email  This e-mail address is being protected from spambots. You need JavaScript enabled to view it
www.mpdvoice.org.uk

A support network for people with MPDs (myeloproliferative disorders) providing information and support.

Leukaemia CARE
1 Birch Court, Blackpole East, Worcester
WR3 8SG
Tel 0800 169 6680
Email  This e-mail address is being protected from spambots. You need JavaScript enabled to view it
www.leukaemiacare.org.uk

A national group promoting the welfare of people with leukaemia and other blood disorders, including non-Hodgkin lymphoma. Has regional support groups in many counties. 

Provides information on myeloproliferative diseases and other blood disorders.

ReferencesBack to top

This section has been compile