Myelofibrosis Signs and Symptoms

Clinical Presentation of Myelofibrosis

Disease-associated symptoms and clinical findings of myelofibrosis are listed below.1,2

Most common1:

  • Fatigue
  • Fever
  • Weight loss
  • Anemia
  • Leukoerythroblastosis
  • Pruritus2
  • Night sweats
  • Splenomegaly
  • Increased or decreased WBC levels
  • Bone marrow fibrosis

Other possible1:

  • Hepatomegaly
  • Lymphadenopathy
  • Pleural effusion
  • Osteosclerosis
  • Periostitis
  • Portal hypertension
  • Ascites
  • Nerve or spinal cord compression
  • Hypertrophic osteoarthropathy
  • Megakaryocytic dysplasia

Investigators created the Myeloproliferative Neoplasm-Symptom Assessment Form Total Symptom Score (MPN-SAF TSS), a 10-item instrument designed to assess the most representative and clinically relevant symptoms among patients with MPNs. The tool records the patient's assessment of the incidence and severity of these disease-related symptoms.3

WBC = white blood cell

Self-Reported Symptoms of Myelofibrosis3
image of graph that shows the percentage of self-reported myelofibrosis symptoms broken out by symptoms
Symptom assessment of 293 patients with myelofibrosis. Incidence is a score of >0 on the MPN-SAF TSS. Symptom severity was rated on a 0 (absent/as good as it can be) to 10 (worst imaginable/as bad as it can be) scale.3 The MPN-SAF TSS has a possible range of 0 to 100, with 100 representing the highest level of symptom severity. Fatigue was independently measured by coadministration of the Brief Fatigue Inventory.3

Most Patients With Myelofibrosis Present With Splenomegaly at Diagnosis

Approximately 90% of patients with myelofibrosis present with splenomegaly at the time of diagnosis.4 Symptoms related to splenomegaly include abdominal fullness, early satiety, and pain under the left ribs.1

image shows an enlarged spleen on patient torso
Marked splenomegaly in myelofibrosis.
References

1. Abdel-Wahab OI, Levine RL. Annu Rev Med. 2009;60:233-245. 2. Barosi G. J Clin Oncol. 1999;17:2954-2970. 3. Emanuel RM, Dueck AC, Geyer HL, et al. J Clin Oncol. 2012;30(33):4098-4103. 4. Cervantes F, Dupriez B, Pereira A, et al. Blood. 2009;113:2895-2901.

 
Resources
By: World Health Organization (WHO)
A diagnostic worksheet from the WHO for primary MF, PV, and ET.
By: International Working Group for Myeloproliferative Neoplasms Research and Treatment (IWG-MRT)
Diagnostic criteria from the IWG-MRT.