After a diagnosis of myelofibrosis (MF), the next step is for you and your doctor to decide on treatment. There are many options based on how serious your condition is, your overall health, and other factors.
MF Treatment Planning
Your doctor may use a scoring system to figure out which MF treatments could help you the most. It considers different things about your cancer and general health to help decide how serious your disease is and the best treatment approach for your case.
Suppose your doctor discovers that you have high-risk myelofibrosis. In that case, they may consider a more intense treatment, such as a stem cell transplant.
MF Risk Factors and Groups
Doctors use the Dynamic International Prognostic Scoring System (DIPSS) to guide treatment plans for MF. The system uses the following eight possible factors to tell whether you have low-, intermediate-, or high-risk MF:
- You’re older than 65.
- Fatigue, night sweats, fever, weight loss (called constitutional symptoms)
- Hemoglobin lower than 10 g/dL
- White blood cell count higher than 25 x109/L
- Peripheral blood blasts, which are abnormal cancerous cells, higher than 1%
- Platelet count less than 100 x109/L
- You need a transfusion.
- Chromosome abnormalities
After looking at all eight possible signs of MF, your doctor will place you in one of these risk groups:
- Low-risk: You have no risk factors.
- Intermediate-1 risk (INT-1): You have one risk factor.
- Intermediate-2 risk (INT-2): You have two or three risk factors.
- High-risk: You have four or more risk factors.
Treatment Options for Intermediate or High-Risk MF
Treatment for MF focuses on making you feel better by easing symptoms of the disease. The only cure for MF is a bone marrow (stem cell) transplant. Still, this treatment takes a toll on your body. It isn’t possible for many people, especially older adults and people with other health problems. MF tends to affect older adults.
Drug therapy
Your doctor may suggest prescription drugs to treat people with intermediate-1 risk (INT-1) MF, including these Janus kinase (JAK) inhibitors, which work by slowing down the overactivity of the immune system that can lead to inflammation and pain:
- Momelotinib (Ojjaara)
- Pacritinib (Vonjo)
- Ruxolitinib (Jakafi)
For intermediate-2 risk (INT-2) or high-risk MF, your doctor could prescribe the same drugs or another JAK inhibitor called fedratinib (Inrebic).
Stem cell transplant
A stem cell transplant (also called a bone marrow transplant) is the only possible cure for MF, but it comes with a high chance of serious side effects. This treatment is usually not suggested for older adults or those with other health issues. Some older adults may be able to have a stem cell transplant if they’re healthy enough and there’s a suitable donor.
Before the procedure, you’ll need chemotherapy or radiation therapy to get rid of unhealthy bone marrow. Then, you’ll get an infusion of healthy blood stem cells from a donor. After treatment, there’s a chance your body’s healthy tissues could reject the new stem cells, called graft-versus-host disease.
Clinical trials
For some people with MF, joining a clinical trial might be the best option for treatment. When you take part in a clinical trial, you play a crucial role in helping to create new and better treatments for MF. And you’ll have access to more treatment choices.
Palliative care
Palliative care is a special type of medical care that aims to ease pain and other symptoms in people dealing with a serious illness like MF. It works alongside other treatments, like surgery or chemotherapy, to offer extra support to you and your family. When used with other therapies, palliative care may improve your well-being and extend your life.
MF Treatment Side Effects
Treatment for MF comes with the chance of possible side effects. Before starting a treatment, talk to your doctor about what to expect. You may be able to control or even avoid side effects with other medicines or therapies. Side effects vary based on the treatment type and dose, your age, and other health problems you might have. They include:
- Fever
- Chills
- Dizziness
- Shortness of breath
- Tingling, pain, burning, and numbness in your hands and feet (peripheral neuropathy)
- Temporary hair loss
- Extreme tiredness (fatigue)
- Nausea
Show Sources
Photo Credit: Numstocker/Shutterstock
SOURCES:
Leukemia & Lymphoma Society: “Myelofibrosis.”
Leukemia Research: “The Myelofibrosis Symptom Assessment Form (MFSAF): An Evidence-based Brief Inventory to Measure Quality of Life and Symptomatic Response to Treatment in Myelofibrosis.”
Mayo Clinic: “Myelofibrosis.”
