Chronic Idiopathic Myelofibrosis, Essential Thrombocythemia, Neutrophilic Leukemia

by National Cancer Institute

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Chronic Idiopathic Myelofibrosis

Chronic idiopathic myelofibrosis is a disease in which abnormal blood cells and fibers build up inside the bone marrow.

The bone marrow is made of tissues that make blood cells (red blood cells, white blood cells, and platelets) and a web of fibers that support the blood-forming tissues. In chronic idiopathic myelofibrosis, large numbers of bone marrow stem cells develop into blood cells that do not mature properly (blasts). The web of fibers inside the bone marrow also becomes very thick (like scar tissue) and slows the blood-forming tissue's ability to make blood cells. This causes the blood-forming tissues to make fewer and fewer blood cells. In order to make up for the low number of blood cells made in the bone marrow, the liver and spleen begin to make the blood cells.

Possible signs of chronic idiopathic myelofibrosis include pain below the ribs on the left side and feeling very tired.

Chronic idiopathic myelofibrosis often does not cause early symptoms. It is sometimes found during a routine blood test. The following symptoms may be caused by chronic idiopathic myelofibrosis or by other conditions. A doctor should be consulted if any of these problems occur:

• Feeling pain or fullness below the ribs on the left side.
• Feeling full sooner than normal when eating.
• Feeling very tired.
• Shortness of breath.
• Easy bruising or bleeding.
• Petechiae (flat, red, pinpoint spots under the skin that are caused by bleeding).
• Fever.
• Night sweats.
• Weight loss.

A special blood test is used to diagnose chronic idiopathic myelofibrosis.

In addition to a complete blood count, bone marrow aspiration and biopsy, and cytogenetic analysis, a peripheral blood smear is used to diagnose chronic idiopathic myelofibrosis. A peripheral blood smear is a procedure in which a sample of blood is checked for tear drop-shaped red blood cells, the number and kinds of white blood cells, the number of platelets, and the presence of blast cells.

Certain factors affect prognosis (chance of recovery) and treatment options for chronic idiopathic myelofibrosis.

Prognosis (chance of recovery) depends on the following:

• The age of the patient.
• The number of abnormal red blood cells and white blood cells.
• The number of blasts in the blood.
• Whether there are certain changes in the chromosomes.
• Whether the patient has symptoms such as fever, night sweats, or weight loss

Essential Thrombocythemia

Essential thrombocythemia is a disease in which too many platelets are made in the bone marrow.

Essential thrombocythemia causes an abnormal increase in the number of platelets made in the blood and bone marrow.

Patients with essential thrombocythemia may have no symptoms.

Essential thrombocythemia often does not cause early symptoms. It is sometimes found during a routine blood test. The following symptoms may be caused by essential thrombocytopenia or by other conditions. A doctor should be consulted if any of these problems occur:

• Headache.
• Burning or tingling in the hands or feet.
• Redness and warmth of the hands or feet.
• Vision or hearing problems.

Platelets are sticky. When there are too many platelets, they may clump together and make it hard for the blood to flow. Clots may form in blood vessels and there may also be increased bleeding. These can cause serious health problems such as stroke or heart attack.

Certain factors affect prognosis (chance of recovery) and treatment options for essential thrombocythemia.

Prognosis (chance of recovery) and treatment options depend on the following:

• The age of the patient.
• Whether the patient has symptoms or other problems related to essential thrombocythemia.

Chronic Neutrophilic Leukemia

Chronic neutrophilic leukemia is a disease in which too many stem cells develop into a type of white blood cell called neutrophils. Neutrophils are infection-fighting blood cells that surround and destroy dead cells and foreign substances (such as bacteria). The spleen and liver may swell because of the extra neutrophils. Chronic neutrophilic leukemia may stay the same or it may progress quickly to acute leukemia.

Chronic Eosinophilic Leukemia

Chronic eosinophilic leukemia is a disease in which too many white blood cells (eosinophils) are made in the bone marrow.

Eosinophils are white blood cells that react to allergens (substances that cause an allergic response) and help fight infections caused by certain parasites. In chronic eosinophilic leukemia, there are too many eosinophils in the blood, bone marrow, and other tissues. Chronic eosinophilic leukemia may stay the same for many years or it may progress quickly to acute leukemia.

Possible signs of chronic eosinophilic leukemia include fever and feeling very tired.

Chronic eosinophilic leukemia may not cause early symptoms. It is sometimes found during a routine blood test. The following symptoms may be caused by chronic eosinophilic leukemia or by other conditions. A doctor should be consulted if any of these problems occur:

• Fever.
• Feeling very tired.
• Cough.
• Swelling under the skin around the eyes and lips, in the throat, or on the hands and feet.
• Muscle pain.
• Itching.
• Diarrhea.

Stages of Chronic Myeloproliferative Disorders

Staging is the process used to find out how far the cancer has spread. There is no standard staging system for chronic myeloproliferative disorders. Treatment is based on the type of myeloproliferative disorder the patient has. It is important to know the type in order to plan treatment.

About the Author

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