How is MF Treated?
The majority of MPN treatments are aimed at managing symptoms and reducing complications of the disease, so that your quality of life is better.
My primary objective in considering a new treatment option for a patient is how appropriate it is to the individual’s circumstance.
For most people, MF treatment does not cure the disease. Rather, the goal of treatment is to reduce symptoms, improve survival and quality of life. This means that the treatment you receive for MF will depend on the symptoms you are experiencing. It is therefore important that you understand your symptoms so that you and your haematologist can create the treatment plan that suits you best. Whatever your symptoms, or even if you aren’t yet experiencing symptoms, you can learn more about the variety of treatment approaches here.
Remember, even mild symptoms can have a significant impact on your day-to-day life and if they do, it’s important to address these with your haematologist.
Options that are available to manage your disease:
Bone marrow or stem cell transplant: A bone marrow or stem cell transplant offers the only curative treatment for MF. However, transplants are not commonly recommended, as there is a high risk of life-threatening side effects. The first step of the treatment involves very high levels of chemotherapy or radiation therapy. After the procedure, there's a risk that the new stem cells will react against your body's healthy tissues. Transplants are only really considered an option for younger patients with more advanced disease. Before you have any treatment you should speak to your haematologist about the aims of the treatment and ensure you have full information about:
- The type and extent of the treatment
- The advantages and disadvantages of the treatment
- Any possible alternative treatments that may be available
- Any significant risks or side effects of the treatment
Management of an enlarged spleen
An enlarged spleen is a common symptom of MF, often leading to pain, discomfort and a feeling of fullness or a loss of appetite. Treatment options include splenectomy and radiotherapy:
- Splenectomy (surgical removal of the spleen).
This is considered if your enlarged spleen is painful and causing complications. However, as all surgical procedures carry some risks; other treatment options are often tried first.
Radiotherapy or radiation of the spleen is an option if splenectomy is ruled out. Performed in hospital, radiotherapy helps to reduce the size of the spleen and can also relieve other related symptoms, such as bone pain.
Management of anaemia
Anaemia is a common symptom of MF. Symptoms of anaemia include excessive tiredness, weakness and shortness of breath. If these symptoms are causing you difficulties, your haematologist may suggest:
- Blood transfusions.
A blood transfusion involves the replacement of your red blood cells with the red blood cells of a compatible donor. Blood transfusions can increase red blood cell count and quickly reduce symptoms of anaemia, often within 24 hours. Periodic blood transfusions are usually only offered to people experiencing severe anaemia.
- Erythropoiesis-stimulating agents (ESAs):
Erythropoietin (EPO) is a natural substance made in your body by the kidneys. Synthetic ESA drugs act like the natural erythropoietin, and can be injected under the skin to increase red blood cells.
Your haematologist will be able to discuss your options based on your individual circumstances.
Watch and wait approach: Some people have no symptoms when they are first diagnosed with MF and are put on what is called a ‘watch and wait’ approach, especially if there is no anaemia, enlarged spleen or other complications. This means that your symptoms will be monitored and if they develop or the disease progresses, you will then be started on a suitable treatment. If you have been placed on a watch and wait approach, it is important that you regularly monitor your body for any changes in symptoms. You can do this with the MPN10 form. This is a simple tool to measure your symptoms and can be printed and taken to your haematologist.