Myeloproliferative Disorders

Myeloproliferative Disorders - General Information

• Chronic myelogenous leukemia (CML) – that is cancer of the bone marrow which produces abnormal granulocytes (which are a type of white blood cells) in the bone marrow.
• Myelofibrosis (known as Myelosclerosis) – that is an overproduction of the collagen or fibrous tissue in the bone marrow, and this makes it harder for the bone marrow to produce blood cells.
• Polycythemia Vera – is an overproduction of blood cells by the bone marrow, especially the red blood cells.
• Thrombocytosis – is an overproduction of the platelet cells. The platelet cells are the cells that promote blood clothing.

Myeloproliferative Disorders usually develop slowly and do not cause life threatening symptoms, but the complications of these diseases can be serious. Here is a list of these complications:

• Enlargement of the spleen and liver
• Gout
• Anemia
• Bleeding
• Kidney or liver failure
• Heart attacks or stroke
• Infection
• Chronic myelogenous leukemia can transform into acute leukemia, a more toxic condition.

The survival rate among patients that have Myeloproliferative Disorders depends on the type of disorder and the kind of symptoms that each person experiences.

Myeloproliferative Disorders – Symptoms

It is well known that any medical disorder (including Myeloproliferative Disorders) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed here. This is why we strongly recommend you to contact your health care provider whenever you develop any unusual, bothersome or unpleasant symptoms.
The majority of the patients with Myeloproliferative Disorders have no symptoms when their doctors make the first diagnosis. The enlarged spleen that can lead to abdominal pain is the common sign of all these disorders except Thrombocytosis. Here are the specific symptoms for every disorder:

• Chronic myelogenous leukemia (CML):
• Fatigue, general malaise
• Weight loss or loss of appetite
• fever and night sweats
• Bone or joint pain
• Heart attack or stroke
• Difficulty breathing
• Gastrointestinal bleeding
• Infection
• Myelofibrosis (known as Myelosclerosis):
• Fatigue, general malaise
• Difficulty breathing
• Anemia
• Weight loss
• fever and night sweats
• Abnormal bleeding
• Polycythemia Vera:
• Fatigue, general malaise
• Difficulty breathing
• Intense itching after bathing in warm water
• Stomach aches
• Purple spots or patches on the skin
• Nosebleeds, gum or stomach bleeding, or blood in the urine
• Throbbing or burning pain in the skin, often with darkened areas
• Headache and visual disturbances
• High blood pressure
• Blockage of blood vessels
• Thrombocytosis:
• Heart attack or stoke
• Headache
• Burning or throbbing pain, redness, and swelling of the hands and feet
• Bruising
• Gastrointestinal bleeding or blood in the urine

Myeloproliferative Disorders – Treatment

The Myeloproliferative Disorders develop from an overproduction of one or more types of blood cells. There has not been discovered the cause of this abnormal increase, but there are some theories:

• Environment - Myeloproliferative Disorders can develop as a result to overexposure to radiation, electrical wiring and chemicals.
• Genetics – some patients that have been diagnosed with CML have an abnormally shortened chromosome which is known as Philadelphia chromosome.

There have not been found cures for most of Myeloproliferative Disorders, but there are several treatments which may help to ameliorate the symptoms and prevent the complications which are associated with these disorders:

• Chronic myelogenous leukemia – a bone marrow transplant is the only hope for patients to cure.
• Myelofibrosis- in this case the symptoms may be treated with medications.
• Polycythemia Vera – in this case the doctors can lower the amount of red blood cells by removing the blood.
• Thrombocytosis – the symptoms may be treated with medications.

A doctor can prescribe medications for a specific disorder based on the symptoms of the patient. Here is a list of medications that can be used in each of the disorders mentioned above:

• Chronic myelogenous leukemia (CML):
• Hydroxyurea – reduces the number of white blood cells.
• Allopurinol - can prevent gout that is a potential complication of CML.
• Interferon - helps the immune system combat cancer cells. Used only if bone marrow transplant is not an option or has failed.
• Chemotherapies (such as cytarabine and daunorubicin) - helps the immune system combat cancer cells.
• Hydroxyurea – can control the complications, such as enlargement of the liver and spleen and reduce the number of white cells and platelets in the blood.
• Hydroxyurea – reduces the number of platelets.
• Salicylates (such as aspirin) - reduce skin redness and burning, and lower increased temperature.
• Antihistamines - decreases itching.
• Allopurinol - reduces symptoms of gout, a potential complication this disorder.

• aspirin - low doses treat headache and burning pain in the skin.
• Hydroxyurea - reduces the number of blood platelets.
• Aminocaproic acid - reduces bleeding.

In Chronic myelogenous leukemia and the late stage of Polycythemia Vera, the blood cells are produced in other locations than the blood marrow, such as liver and spleen (this way it is explained the enlargement of these organs). In the case of the spleen if it becomes very painful, doctors can perform a surgery to remove this organ – splenectomy. In serious cases of Myelofibrosis, the doctors may replace during a surgery the abnormal stem cells from the bone marrow with healthy stem cells, this procedure is called stem cell transplant and carries a high degree of risk. Phlebotomy can prevent the accumulation of blood and the decrease the risk of stroke in the patients that suffer from Polycythemia Vera. A well done treatment for Myeloproliferative Disorders includes a range of complementary-alternative therapies, especially in what concerns nutrition: some nutritional supplements can reduce the symptoms of a part of the disorders, but not all of them.