Myelofibrosis history and symptoms: Difference between revisions

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===Common Symptoms===
===Common Symptoms===
Common symptoms of myelofibrosis include:
Common symptoms of myelofibrosis include:
*Fatigue (the most common)<ref name="pmid30472746">{{cite journal |vauthors=Birgegard G, Samuelsson J, Ahlstrand E, Ejerblad E, Enevold C, Ghanima W, Hasselbalch H, Nielsen CH, Knutsen H, Pedersen OB, Sørensen A, Andreasson B |title=Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group |journal=Eur. J. Haematol. |volume= |issue= |pages= |date=November 2018 |pmid=30472746 |doi=10.1111/ejh.13198 |url=}}</ref><ref name="pmid30100963">{{cite journal |vauthors=Chahdi H, Oukabli M |title=[A special form of pancytopenia] |language=French |journal=Pan Afr Med J |volume=29 |issue= |pages=209 |date=2018 |pmid=30100963 |pmc=6080970 |doi=10.11604/pamj.2018.29.209.14055 |url=}}</ref><ref name="pmid30039550">{{cite journal |vauthors=Tefferi A |title=Primary myelofibrosis: 2019 update on diagnosis, risk-stratification and management |journal=Am. J. Hematol. |volume=93 |issue=12 |pages=1551–1560 |date=December 2018 |pmid=30039550 |doi=10.1002/ajh.25230 |url=}}</ref>
*Fatigue (the most common)<ref name="pmid30472746">{{cite journal |vauthors=Birgegard G, Samuelsson J, Ahlstrand E, Ejerblad E, Enevold C, Ghanima W, Hasselbalch H, Nielsen CH, Knutsen H, Pedersen OB, Sørensen A, Andreasson B |title=Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group |journal=Eur. J. Haematol. |volume= |issue= |pages= |date=November 2018 |pmid=30472746 |doi=10.1111/ejh.13198 |url=}}</ref><ref name="pmid30100963">{{cite journal |vauthors=Chahdi H, Oukabli M |title=[A special form of pancytopenia] |language=French |journal=Pan Afr Med J |volume=29 |issue= |pages=209 |date=2018 |pmid=30100963 |pmc=6080970 |doi=10.11604/pamj.2018.29.209.14055 |url=}}</ref><ref name="pmid30039550">{{cite journal |vauthors=Tefferi A |title=Primary myelofibrosis: 2019 update on diagnosis, risk-stratification and management |journal=Am. J. Hematol. |volume=93 |issue=12 |pages=1551–1560 |date=December 2018 |pmid=30039550 |doi=10.1002/ajh.25230 |url=}}</ref><ref name="pmid26876249">{{cite journal |vauthors=Xu J, Xu Z, Wang J, Li B, Sun X, Qin T, Zhang Y, Zhang H, Fang L, Pan L, Hu N, Qu S, Xiao Z |title=[The assessment of symptomatic burden among Ph/BCR- ABL negative myeloproliferative neoplasm patients] |language=Chinese |journal=Zhonghua Xue Ye Xue Za Zhi |volume=37 |issue=1 |pages=26–9 |date=January 2016 |pmid=26876249 |doi=10.3760/cma.j.issn.0253-2727.2016.01.005 |url=}}</ref>
*Weight loss
*Weight loss
*Night sweats<ref name="Tefferi2000">{{cite journal|last1=Tefferi|first1=Ayalew|title=Myelofibrosis with Myeloid Metaplasia|journal=New England Journal of Medicine|volume=342|issue=17|year=2000|pages=1255–1265|issn=0028-4793|doi=10.1056/NEJM200004273421706}}</ref>
*Night sweats<ref name="Tefferi2000">{{cite journal|last1=Tefferi|first1=Ayalew|title=Myelofibrosis with Myeloid Metaplasia|journal=New England Journal of Medicine|volume=342|issue=17|year=2000|pages=1255–1265|issn=0028-4793|doi=10.1056/NEJM200004273421706}}</ref>
Line 27: Line 27:
*Early satiety
*Early satiety
*Left subcostal pain
*Left subcostal pain
===Less Common Symptoms===
*No symptoms
*Bleeding<ref name="pmid30405096">{{cite journal |vauthors=Finazzi G, Vannucchi AM, Barbui T |title=Prefibrotic myelofibrosis: treatment algorithm 2018 |journal=Blood Cancer J |volume=8 |issue=11 |pages=104 |date=November 2018 |pmid=30405096 |pmc=6221891 |doi=10.1038/s41408-018-0142-z |url=}}</ref><ref name="pmid29898956">{{cite journal |vauthors=Hofmann I, Geer MJ, Vögtle T, Crispin A, Campagna DR, Barr A, Calicchio ML, Heising S, van Geffen JP, Kuijpers MJE, Heemskerk JWM, Eble JA, Schmitz-Abe K, Obeng EA, Douglas M, Freson K, Pondarré C, Favier R, Jarvis GE, Markianos K, Turro E, Ouwehand WH, Mazharian A, Fleming MD, Senis YA |title=Congenital macrothrombocytopenia with focal myelofibrosis due to mutations in human G6b-B is rescued in humanized mice |journal=Blood |volume=132 |issue=13 |pages=1399–1412 |date=September 2018 |pmid=29898956 |doi=10.1182/blood-2017-08-802769 |url=}}</ref><ref name="pmid28808761">{{cite journal |vauthors=Kc D, Falchi L, Verstovsek S |title=The underappreciated risk of thrombosis and bleeding in patients with myelofibrosis: a review |journal=Ann. Hematol. |volume=96 |issue=10 |pages=1595–1604 |date=October 2017 |pmid=28808761 |pmc=5693670 |doi=10.1007/s00277-017-3099-2 |url=}}</ref><ref name=complmf1radio1>Complications of primary myelofibrosis. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2016. http://radiopaedia.org/articles/myelofibrosis. Accessed on March 10, 2016</ref>
*Petechiae or ecchymoses
*Gout<ref name="pmid5216775">{{cite journal |vauthors=Yü TF |title=Secondary gout associated with myeloproliferative diseases |journal=Arthritis Rheum. |volume=8 |issue=5 |pages=765–71 |date=October 1965 |pmid=5216775 |doi= |url=}}</ref><ref name="pmid702809">{{cite journal |vauthors=Nagai Y, Ikebe K, Ito K, Nishizawa T, Akaoka I, Muranaka M, Horiuchi Y |title=[A case of secondary gout associated with myelofibrosis following polycythemia vera (author's transl)] |language=Japanese |journal=Rinsho Ketsueki |volume=19 |issue=3 |pages=226–33 |date=March 1978 |pmid=702809 |doi= |url=}}</ref><ref name="pmid1062009">{{cite journal |vauthors=Yu T, Weinreb N, Wittman R, Wasserman LR |title=Secondary gout associated with chronic myeloproliferative disorders |journal=Semin. Arthritis Rheum. |volume=5 |issue=3 |pages=247–56 |date=February 1976 |pmid=1062009 |doi= |url=}}</ref>
*Renal stones<ref>{{cite book | last = Hoffman | first = Ronald | title = Hematology : basic principles and practice | publisher = Elsevier | location = Philadelphia, PA | year = 2018 | isbn = 9780323357623 }}</ref>
*Hepatomegaly<ref name="pmid23619118">{{cite journal |vauthors=Henry M, Chitlur M, Rajpurkar M, Mastropietro CW, Poulik J, Ravindranath Y |title=Myelofibrosis, hepatic extramedullary hematopoiesis and ascites associated with vitamin D deficiency in early infancy |journal=J. Pediatr. Hematol. Oncol. |volume=36 |issue=4 |pages=319–21 |date=May 2014 |pmid=23619118 |doi=10.1097/MPH.0b013e31828e548a |url=}}</ref>
*Jaundice
*Evidence of portal hypertension<ref name="pmid22851873">{{cite journal |vauthors=Tokai K, Miyatani H, Yoshida Y, Yamada S |title=Multiple esophageal variceal ruptures with massive ascites due to myelofibrosis-induced portal hypertension |journal=World J. Gastroenterol. |volume=18 |issue=28 |pages=3770–4 |date=July 2012 |pmid=22851873 |pmc=3406433 |doi=10.3748/wjg.v18.i28.3770 |url=}}</ref><ref name="pmid11293952">{{cite journal |vauthors=Bĕlohlávek J, Schwarz J, Jirásek A, Krajina A, Polák F, Hrubý M |title=Idiopathic myelofibrosis complicated by portal hypertension treated with a transjugular intrahepatic portosystemic shunt (TIPS) |journal=Wien. Klin. Wochenschr. |volume=113 |issue=5-6 |pages=208–11 |date=March 2001 |pmid=11293952 |doi= |url=}}</ref><ref name="pmid24501543">{{cite journal |vauthors=Mughal TI, Vaddi K, Sarlis NJ, Verstovsek S |title=Myelofibrosis-associated complications: pathogenesis, clinical manifestations, and effects on outcomes |journal=Int J Gen Med |volume=7 |issue= |pages=89–101 |date=2014 |pmid=24501543 |pmc=3912063 |doi=10.2147/IJGM.S51800 |url=}}</ref><ref name="pmid17301514">{{cite journal |vauthors=Doki N, Irisawa H, Takada S, Sakura T, Miyawaki S |title=Transjugular intrahepatic portosystemic shunt for the treatment of portal hypertension due to idiopathic myelofibrosis |journal=Intern. Med. |volume=46 |issue=4 |pages=187–90 |date=2007 |pmid=17301514 |doi= |url=}}</ref>
*Peripheral edema<ref>{{cite book | last = Hoffman | first = Ronald | title = Hematology : basic principles and practice | publisher = Elsevier | location = Philadelphia, PA | year = 2018 | isbn = 9780323357623 }}</ref>
*Lymphadenopathy
*Depression<ref name="pmid27458250">{{cite journal |vauthors=Eckert R, Huberty J, Gowin K, Mesa R, Marks L |title=Physical Activity as a Nonpharmacological Symptom Management Approach in Myeloproliferative Neoplasms: Recommendations for Future Research |journal=Integr Cancer Ther |volume=16 |issue=4 |pages=439–450 |date=December 2017 |pmid=27458250 |pmc=5739136 |doi=10.1177/1534735416661417 |url=}}</ref>


Symptoms of myelofibrosis include:<ref name=symptomsofmyelofibrosis1>Symptoms of myelofibrosis. US National Library of Medicine 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000531.htm. Accessed on March 7, 2016</ref><ref name=cancercanadiansymptomsidiopathicmyelofibrosis1>Symptoms of idiopathic myelofibrosis. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/idiopathic-myelofibrosis/?region=on. Accessed on March 9, 2016</ref><ref name=symptoimmfgovcNCER1>Symptoms of primary myelofibrosis include pain below the ribs on the left side and feeling very tired. National cancer institute 2016. http://www.cancer.gov/types/myeloproliferative/patient/chronic-treatment-pdq#section/_234. Accessed on March 10, 2016</ref>
Symptoms of myelofibrosis include:<ref name=symptomsofmyelofibrosis1>Symptoms of myelofibrosis. US National Library of Medicine 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000531.htm. Accessed on March 7, 2016</ref><ref name=cancercanadiansymptomsidiopathicmyelofibrosis1>Symptoms of idiopathic myelofibrosis. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/idiopathic-myelofibrosis/?region=on. Accessed on March 9, 2016</ref><ref name=symptoimmfgovcNCER1>Symptoms of primary myelofibrosis include pain below the ribs on the left side and feeling very tired. National cancer institute 2016. http://www.cancer.gov/types/myeloproliferative/patient/chronic-treatment-pdq#section/_234. Accessed on March 10, 2016</ref>

Revision as of 19:41, 3 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

A significant proportion of patients with myelofibrosis can be asymptomatic. The hallmark of the disease is pancytopenia. A positive history of fatigue, recurring infections, and bleeding complications is suggestive of myelofibrosis. The most common symptom is fatigue which is prominent enough as it remarkably affects the quality of life. Fatigue, a result of anemia, leads to the associated complaints of weakness, palpitations, and dyspnea on exertion. Other nonspecific symptoms such as fever, night sweats, and weight loss can also be present at diagnosis.

History and Symptoms

History

Patients with myelofibrosis may have a positive history of:

  • Fatigue (the most commonly reported)[1][2][3]
  • Night sweats[4]
  • Bone pain[5]
  • Fever[6][7]
  • Weight loss[4]
  • Generalized abdominal pain[8][9]
  • Left subcostal pain
  • Early satiety

Common Symptoms

Common symptoms of myelofibrosis include:

  • Fatigue (the most common)[1][2][3][10]
  • Weight loss
  • Night sweats[4]
  • Fever[6][7]
  • Generalized abdominal pain[8][9]
  • Early satiety
  • Left subcostal pain

Less Common Symptoms

Symptoms of myelofibrosis include:[26][27][28]

References

  1. 1.0 1.1 Birgegard G, Samuelsson J, Ahlstrand E, Ejerblad E, Enevold C, Ghanima W, Hasselbalch H, Nielsen CH, Knutsen H, Pedersen OB, Sørensen A, Andreasson B (November 2018). "Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group". Eur. J. Haematol. doi:10.1111/ejh.13198. PMID 30472746.
  2. 2.0 2.1 Chahdi H, Oukabli M (2018). "[A special form of pancytopenia]". Pan Afr Med J (in French). 29: 209. doi:10.11604/pamj.2018.29.209.14055. PMC 6080970. PMID 30100963.
  3. 3.0 3.1 Tefferi A (December 2018). "Primary myelofibrosis: 2019 update on diagnosis, risk-stratification and management". Am. J. Hematol. 93 (12): 1551–1560. doi:10.1002/ajh.25230. PMID 30039550.
  4. 4.0 4.1 4.2 Tefferi, Ayalew (2000). "Myelofibrosis with Myeloid Metaplasia". New England Journal of Medicine. 342 (17): 1255–1265. doi:10.1056/NEJM200004273421706. ISSN 0028-4793.
  5. Gwaltney C, Paty J, Kwitkowski VE, Mesa RA, Dueck AC, Papadopoulos EJ, Wang L, Feliciano J, Coons SJ (August 2017). "Development of a harmonized patient-reported outcome questionnaire to assess myelofibrosis symptoms in clinical trials". Leuk. Res. 59: 26–31. doi:10.1016/j.leukres.2017.05.012. PMID 28544906.
  6. 6.0 6.1 Mitra D, Kaye JA, Piecoro LT, Brown J, Reith K, Mughal TI, Sarlis NJ (December 2013). "Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review". Cancer Med. 2 (6): 889–98. doi:10.1002/cam4.136. PMC 3892393. PMID 24403262.
  7. 7.0 7.1 Mesa RA, Shields A, Hare T, Erickson-Viitanen S, Sun W, Sarlis NJ, Sandor V, Levy RS, Verstovsek S (August 2013). "Progressive burden of myelofibrosis in untreated patients: assessment of patient-reported outcomes in patients randomized to placebo in the COMFORT-I study". Leuk. Res. 37 (8): 911–6. doi:10.1016/j.leukres.2013.04.017. PMID 23684482.
  8. 8.0 8.1 Pizzi M, Gergis U, Chaviano F, Orazi A (September 2016). "The effects of hematopoietic stem cell transplant on splenic extramedullary hematopoiesis in patients with myeloproliferative neoplasm-associated myelofibrosis". Hematol Oncol Stem Cell Ther. 9 (3): 96–104. doi:10.1016/j.hemonc.2016.07.002. PMID 27521149.
  9. 9.0 9.1 Mohyuddin GR, Yacoub A (2016). "Primary Myelofibrosis Presenting as Extramedullary Hematopoiesis in a Transplanted Liver Graft: Case Report and Review of the Literature". Case Rep Hematol. 2016: 9515404. doi:10.1155/2016/9515404. PMC 4739215. PMID 26885416.
  10. Xu J, Xu Z, Wang J, Li B, Sun X, Qin T, Zhang Y, Zhang H, Fang L, Pan L, Hu N, Qu S, Xiao Z (January 2016). "[The assessment of symptomatic burden among Ph/BCR- ABL negative myeloproliferative neoplasm patients]". Zhonghua Xue Ye Xue Za Zhi (in Chinese). 37 (1): 26–9. doi:10.3760/cma.j.issn.0253-2727.2016.01.005. PMID 26876249.
  11. Finazzi G, Vannucchi AM, Barbui T (November 2018). "Prefibrotic myelofibrosis: treatment algorithm 2018". Blood Cancer J. 8 (11): 104. doi:10.1038/s41408-018-0142-z. PMC 6221891. PMID 30405096.
  12. Hofmann I, Geer MJ, Vögtle T, Crispin A, Campagna DR, Barr A, Calicchio ML, Heising S, van Geffen JP, Kuijpers M, Heemskerk J, Eble JA, Schmitz-Abe K, Obeng EA, Douglas M, Freson K, Pondarré C, Favier R, Jarvis GE, Markianos K, Turro E, Ouwehand WH, Mazharian A, Fleming MD, Senis YA (September 2018). "Congenital macrothrombocytopenia with focal myelofibrosis due to mutations in human G6b-B is rescued in humanized mice". Blood. 132 (13): 1399–1412. doi:10.1182/blood-2017-08-802769. PMID 29898956. Vancouver style error: initials (help)
  13. Kc D, Falchi L, Verstovsek S (October 2017). "The underappreciated risk of thrombosis and bleeding in patients with myelofibrosis: a review". Ann. Hematol. 96 (10): 1595–1604. doi:10.1007/s00277-017-3099-2. PMC 5693670. PMID 28808761.
  14. Complications of primary myelofibrosis. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2016. http://radiopaedia.org/articles/myelofibrosis. Accessed on March 10, 2016
  15. Yü TF (October 1965). "Secondary gout associated with myeloproliferative diseases". Arthritis Rheum. 8 (5): 765–71. PMID 5216775.
  16. Nagai Y, Ikebe K, Ito K, Nishizawa T, Akaoka I, Muranaka M, Horiuchi Y (March 1978). "[A case of secondary gout associated with myelofibrosis following polycythemia vera (author's transl)]". Rinsho Ketsueki (in Japanese). 19 (3): 226–33. PMID 702809.
  17. Yu T, Weinreb N, Wittman R, Wasserman LR (February 1976). "Secondary gout associated with chronic myeloproliferative disorders". Semin. Arthritis Rheum. 5 (3): 247–56. PMID 1062009.
  18. Hoffman, Ronald (2018). Hematology : basic principles and practice. Philadelphia, PA: Elsevier. ISBN 9780323357623.
  19. Henry M, Chitlur M, Rajpurkar M, Mastropietro CW, Poulik J, Ravindranath Y (May 2014). "Myelofibrosis, hepatic extramedullary hematopoiesis and ascites associated with vitamin D deficiency in early infancy". J. Pediatr. Hematol. Oncol. 36 (4): 319–21. doi:10.1097/MPH.0b013e31828e548a. PMID 23619118.
  20. Tokai K, Miyatani H, Yoshida Y, Yamada S (July 2012). "Multiple esophageal variceal ruptures with massive ascites due to myelofibrosis-induced portal hypertension". World J. Gastroenterol. 18 (28): 3770–4. doi:10.3748/wjg.v18.i28.3770. PMC 3406433. PMID 22851873.
  21. Bĕlohlávek J, Schwarz J, Jirásek A, Krajina A, Polák F, Hrubý M (March 2001). "Idiopathic myelofibrosis complicated by portal hypertension treated with a transjugular intrahepatic portosystemic shunt (TIPS)". Wien. Klin. Wochenschr. 113 (5–6): 208–11. PMID 11293952.
  22. Mughal TI, Vaddi K, Sarlis NJ, Verstovsek S (2014). "Myelofibrosis-associated complications: pathogenesis, clinical manifestations, and effects on outcomes". Int J Gen Med. 7: 89–101. doi:10.2147/IJGM.S51800. PMC 3912063. PMID 24501543.
  23. Doki N, Irisawa H, Takada S, Sakura T, Miyawaki S (2007). "Transjugular intrahepatic portosystemic shunt for the treatment of portal hypertension due to idiopathic myelofibrosis". Intern. Med. 46 (4): 187–90. PMID 17301514.
  24. Hoffman, Ronald (2018). Hematology : basic principles and practice. Philadelphia, PA: Elsevier. ISBN 9780323357623.
  25. Eckert R, Huberty J, Gowin K, Mesa R, Marks L (December 2017). "Physical Activity as a Nonpharmacological Symptom Management Approach in Myeloproliferative Neoplasms: Recommendations for Future Research". Integr Cancer Ther. 16 (4): 439–450. doi:10.1177/1534735416661417. PMC 5739136. PMID 27458250.
  26. Symptoms of myelofibrosis. US National Library of Medicine 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000531.htm. Accessed on March 7, 2016
  27. Symptoms of idiopathic myelofibrosis. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/idiopathic-myelofibrosis/?region=on. Accessed on March 9, 2016
  28. Symptoms of primary myelofibrosis include pain below the ribs on the left side and feeling very tired. National cancer institute 2016. http://www.cancer.gov/types/myeloproliferative/patient/chronic-treatment-pdq#section/_234. Accessed on March 10, 2016


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