New or increasing splenomegaly is a marker of disease progression1

Image of text that says In a study of 1054 patients with primary myelofibrosis (MF), approximately 90% (375/428) of patients for whom data were available had palpable splenomegaly at diagnosis. Data were available for 768 patients, 681 of whom had palpable splenomegaly.
Image of text that says In a study of 1054 patients with primary myelofibrosis (MF), approximately 90% (375/428) of patients for whom data were available had palpable splenomegaly at diagnosis. Data were available for 768 patients, 681 of whom had palpable splenomegaly.

Palpation can be a quick and easy method for detecting and tracking splenomegaly3

A palpable spleen of ≥5 cm below the left costal margin constitutes progressive disease*, according to the International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) and European LeukemiaNet (ELN) response criteria.1

Assessing the spleen at diagnosis and routinely during follow-up allows longitudinal tracking of disease progression.

*Progressive disease assignment for splenomegaly requires confirmation by computed tomography (CT) or magnetic resonance imaging (MRI) showing a ≥25% increase in spleen volume from baseline. Baseline values for both physical examination and imaging studies refer to pretreatment baseline and not to posttreatment measurements.1

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend spleen assessment as part of the workup4

Image of text that says NCCN Guidelines recommend palpating the spleen at diagnosis in all patients with myeloproliferative neoplasms (MPNs)
Image of text that says NCCN Guidelines recommend palpating the spleen at diagnosis in all patients with myeloproliferative neoplasms (MPNs)

Imaging, including ultrasound, may be appropriate for patients with a body habitus which precludes palpation.5

Splenomegaly is more than a clinical indicator, it impacts patients' lives

Symptoms related to splenomegaly include6:

  • Abdominal fullness
  • Early satiety
  • Pain under left rib
Image Ruben A. Mesa, MD, FACP
Early identification of splenomegaly in patients with MF is critical, as it is an important clinical sign. An enlarged spleen can directly cause symptoms (pain, discomfort, early satiety). Since most patients with MF have splenomegaly, if your physical exam does not clearly rule out splenomegaly, consider radiographic imaging to have an accurate assessment.
—Ruben A. Mesa, MD, FACP

References: 1. Tefferi A, Cervantes F, Mesa R, et al. Blood. 2013;122(8):1395-1398. 2. Cervantes F, Dupriez B, Pereira A, et al. Blood. 2009;113(13):2895-2901. 3. Armitage JO. Spleen. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston: Butterworths; 1990. 4. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Myeloproliferative Neoplasms V.2.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed August 18, 2021. To view the most recent and complete version of the guidelines, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content. use or application and disclaims any responsibility for their application or use in any way. 5. Tremblay D, Schwartz M, Bakst R, et al. Ann Hematol. 2020. doi:10.1007/s00277-020-04069-4 6. Abdel-Wahab Ol, Levine RL. Annu Rev Med. 2009;60:233-245.