Myelofibrosis history and symptoms: Difference between revisions

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{{Myelofibrosis}}
{{Myelofibrosis}}
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==Overview==
==Overview==
==History==
A significant proportion of [[Patient|patients]] with [[myelofibrosis]] can be [[asymptomatic]]. The hallmark of the [[disease]] is [[pancytopenia]]. A positive history of [[fatigue]], recurring [[Infection|infections]], and [[bleeding]] [[Complication (medicine)|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]], [[Palpitation|palpitations]], and [[dyspnea]] on [[exertion]]. Other nonspecific [[Symptom|symptoms]] such as [[fever]], [[night sweats]], and [[weight loss]] can also be present at [[diagnosis]].
==Symptoms==
 
Symptoms of myelofibrosis include:
==History and Symptoms==
*Bone pain  
===History===
*Bruising and easy bleeding due to inadequate numbers of [[platelets]]
[[Patient|Patients]] with [[myelofibrosis]] may have a positive history of:
*Fatigue
*[[Fatigue]] (the most commonly reported)<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>
*Increased susceptibility to infection, such as [[pneumonia]] or [[diarrhea]]
*[[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>
*[[Bone pain]]<ref name="pmid28544906">{{cite journal |vauthors=Gwaltney C, Paty J, Kwitkowski VE, Mesa RA, Dueck AC, Papadopoulos EJ, Wang L, Feliciano J, Coons SJ |title=Development of a harmonized patient-reported outcome questionnaire to assess myelofibrosis symptoms in clinical trials |journal=Leuk. Res. |volume=59 |issue= |pages=26–31 |date=August 2017 |pmid=28544906 |doi=10.1016/j.leukres.2017.05.012 |url=}}</ref>
*[[Fever]]<ref name="pmid24403262">{{cite journal |vauthors=Mitra D, Kaye JA, Piecoro LT, Brown J, Reith K, Mughal TI, Sarlis NJ |title=Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review |journal=Cancer Med |volume=2 |issue=6 |pages=889–98 |date=December 2013 |pmid=24403262 |pmc=3892393 |doi=10.1002/cam4.136 |url=}}</ref><ref name="pmid23684482">{{cite journal |vauthors=Mesa RA, Shields A, Hare T, Erickson-Viitanen S, Sun W, Sarlis NJ, Sandor V, Levy RS, Verstovsek S |title=Progressive burden of myelofibrosis in untreated patients: assessment of patient-reported outcomes in patients randomized to placebo in the COMFORT-I study |journal=Leuk. Res. |volume=37 |issue=8 |pages=911–6 |date=August 2013 |pmid=23684482 |doi=10.1016/j.leukres.2013.04.017 |url=}}</ref>
*[[Weight loss]]<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>
*Generalized [[abdominal pain]]<ref name="pmid27521149">{{cite journal |vauthors=Pizzi M, Gergis U, Chaviano F, Orazi A |title=The effects of hematopoietic stem cell transplant on splenic extramedullary hematopoiesis in patients with myeloproliferative neoplasm-associated myelofibrosis |journal=Hematol Oncol Stem Cell Ther |volume=9 |issue=3 |pages=96–104 |date=September 2016 |pmid=27521149 |doi=10.1016/j.hemonc.2016.07.002 |url=}}</ref><ref name="pmid26885416">{{cite journal |vauthors=Mohyuddin GR, Yacoub A |title=Primary Myelofibrosis Presenting as Extramedullary Hematopoiesis in a Transplanted Liver Graft: Case Report and Review of the Literature |journal=Case Rep Hematol |volume=2016 |issue= |pages=9515404 |date=2016 |pmid=26885416 |pmc=4739215 |doi=10.1155/2016/9515404 |url=}}</ref>
*Left [[subcostal]] [[pain]]
*[[Satiety|Early satiety]]
 
===Common Symptoms===
Common [[Symptom|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><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]]<ref name="pmid29631428">{{cite journal |vauthors=Magyari F, Bedekovics J, Décsy J, Ilonczai P, Illés Á, Simon Z |title=[Investigation and treatment of prefibrotic/early primary myelofibrosis. A case study] |language=Hungarian |journal=Orv Hetil |volume=159 |issue=15 |pages=603–609 |date=April 2018 |pmid=29631428 |doi=10.1556/650.2018.30995 |url=}}</ref><ref name="pmid26745128">{{cite journal |vauthors=Sultan S, Irfan SM |title=Primary Idiopathic Myelofibrosis: Clinico-Epidemiological Profile and Risk Stratification in Pakistani Patients |journal=Asian Pac. J. Cancer Prev. |volume=16 |issue=18 |pages=8629–31 |date=2015 |pmid=26745128 |doi= |url=}}</ref><ref name="pmid21883029">{{cite journal |vauthors=Johansson P, Mesa R, Scherber R, Abelsson J, Samuelsson J, Birgegård G, Andréasson B |title=Association between quality of life and clinical parameters in patients with myeloproliferative neoplasms |journal=Leuk. Lymphoma |volume=53 |issue=3 |pages=441–4 |date=March 2012 |pmid=21883029 |doi=10.3109/10428194.2011.619608 |url=}}</ref>
*[[Loss of appetite]]<ref name="pmid23672349">{{cite journal |vauthors=Harrison CN, Mesa RA, Kiladjian JJ, Al-Ali HK, Gisslinger H, Knoops L, Squier M, Sirulnik A, Mendelson E, Zhou X, Copley-Merriman C, Hunter DS, Levy RS, Cervantes F, Passamonti F, Barbui T, Barosi G, Vannucchi AM |title=Health-related quality of life and symptoms in patients with myelofibrosis treated with ruxolitinib versus best available therapy |journal=Br. J. Haematol. |volume=162 |issue=2 |pages=229–39 |date=July 2013 |pmid=23672349 |doi=10.1111/bjh.12375 |url=}}</ref><ref name="pmid29631428">{{cite journal |vauthors=Magyari F, Bedekovics J, Décsy J, Ilonczai P, Illés Á, Simon Z |title=[Investigation and treatment of prefibrotic/early primary myelofibrosis. A case study] |language=Hungarian |journal=Orv Hetil |volume=159 |issue=15 |pages=603–609 |date=April 2018 |pmid=29631428 |doi=10.1556/650.2018.30995 |url=}}</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>
*[[Fever]]<ref name="pmid24403262">{{cite journal |vauthors=Mitra D, Kaye JA, Piecoro LT, Brown J, Reith K, Mughal TI, Sarlis NJ |title=Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review |journal=Cancer Med |volume=2 |issue=6 |pages=889–98 |date=December 2013 |pmid=24403262 |pmc=3892393 |doi=10.1002/cam4.136 |url=}}</ref><ref name="pmid23684482">{{cite journal |vauthors=Mesa RA, Shields A, Hare T, Erickson-Viitanen S, Sun W, Sarlis NJ, Sandor V, Levy RS, Verstovsek S |title=Progressive burden of myelofibrosis in untreated patients: assessment of patient-reported outcomes in patients randomized to placebo in the COMFORT-I study |journal=Leuk. Res. |volume=37 |issue=8 |pages=911–6 |date=August 2013 |pmid=23684482 |doi=10.1016/j.leukres.2013.04.017 |url=}}</ref>
*Generalized [[abdominal pain]]<ref name="pmid27521149">{{cite journal |vauthors=Pizzi M, Gergis U, Chaviano F, Orazi A |title=The effects of hematopoietic stem cell transplant on splenic extramedullary hematopoiesis in patients with myeloproliferative neoplasm-associated myelofibrosis |journal=Hematol Oncol Stem Cell Ther |volume=9 |issue=3 |pages=96–104 |date=September 2016 |pmid=27521149 |doi=10.1016/j.hemonc.2016.07.002 |url=}}</ref><ref name="pmid26885416">{{cite journal |vauthors=Mohyuddin GR, Yacoub A |title=Primary Myelofibrosis Presenting as Extramedullary Hematopoiesis in a Transplanted Liver Graft: Case Report and Review of the Literature |journal=Case Rep Hematol |volume=2016 |issue= |pages=9515404 |date=2016 |pmid=26885416 |pmc=4739215 |doi=10.1155/2016/9515404 |url=}}</ref>
*[[Satiety|Early satiety]]
*Left [[subcostal]] [[pain]]
 
===Less Common Symptoms===
*No [[Symptom|symptoms]]<ref>{{cite book | last = Hoffman | first = Ronald | title = Hematology : basic principles and practice | publisher = Elsevier | location = Philadelphia, PA | year = 2018 | isbn = 9780323357623 }}</ref>
*[[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>
*[[Bruise|Bruising]]
*[[Gout|Painful big toe]]<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>
*[[Kidney stone|Colicky abdominal pain, hematuria]]<ref>{{cite book | last = Hoffman | first = Ronald | title = Hematology : basic principles and practice | publisher = Elsevier | location = Philadelphia, PA | year = 2018 | isbn = 9780323357623 }}</ref>
*[[Abdomen|Abdominal]] swelling<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><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>
*[[Jaundice|Skin and stool color changes]]
*[[Blood|Bloody]] [[Nausea and vomiting|emesis]], spider shaped [[skin]] changes<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>
*Frequent [[Infection|infections]]<ref name="pmid28775247">{{cite journal |vauthors=Fareed S, Nashwan AJ, Abu Jarir S, Husain A, Suliman DS, Ibrahim F, Moustafa A, Akhter MS, Yassin MA |title=Spinal Abscess Caused by Salmonella Bacteremia in a Patient with Primary Myelofibrosis |journal=Am J Case Rep |volume=18 |issue= |pages=859–864 |date=August 2017 |pmid=28775247 |pmc=5551928 |doi= |url=}}</ref><ref name="pmid30057341">{{cite journal |vauthors=Karigane D, Kikuchi T, Sakurai M, Kato J, Yamane Y, Hashida R, Abe R, Hatano M, Hasegawa N, Wakayama M, Shibuya K, Okamoto S, Mori T |title=Invasive hepatic mucormycosis: A case report and review of the literature |journal=J. Infect. Chemother. |volume= |issue= |pages= |date=July 2018 |pmid=30057341 |doi=10.1016/j.jiac.2018.06.013 |url=}}</ref><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>
*[[Cough|Dry cough]]<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>
*[[Pruritis|Itchy skin]]<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="pmid19250674">{{cite journal |vauthors=Mesa RA, Schwager S, Radia D, Cheville A, Hussein K, Niblack J, Pardanani AD, Steensma DP, Litzow MR, Rivera CE, Camoriano J, Verstovsek S, Sloan J, Harrison C, Kantarjian H, Tefferi A |title=The Myelofibrosis Symptom Assessment Form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis |journal=Leuk. Res. |volume=33 |issue=9 |pages=1199–203 |date=September 2009 |pmid=19250674 |pmc=4419687 |doi=10.1016/j.leukres.2009.01.035 |url=}}</ref>
*[[Skin nodules|Skin bumps]]<ref name="pmid18705835">{{cite journal |vauthors=Miyata T, Masuzawa M, Katsuoka K, Higashihara M |title=Cutaneous extramedullary hematopoiesis in a patient with idiopathic myelofibrosis |journal=J. Dermatol. |volume=35 |issue=7 |pages=456–61 |date=July 2008 |pmid=18705835 |doi=10.1111/j.1346-8138.2008.00502.x |url=}}</ref><ref name="pmid18394406">{{cite journal |vauthors=Corella F, Barnadas MA, Bordes R, Curell R, Espinosa I, Vergara C, Alomar A |title=[A case of cutaneous extramedullary hematopoiesis associated with idiopathic myelofibrosis] |language=Spanish; Castilian |journal=Actas Dermosifiliogr |volume=99 |issue=4 |pages=297–300 |date=May 2008 |pmid=18394406 |doi= |url=}}</ref><ref name="pmid10405485">{{cite journal |vauthors=Kwon KS, Lee JB, Jang HS, Chung TA, Oh CK |title=A case of cutaneous extramedullary hematopoiesis in myelofibrosis with a preponderance of eosinophilic precursor cells |journal=J. Dermatol. |volume=26 |issue=6 |pages=379–84 |date=June 1999 |pmid=10405485 |doi= |url=}}</ref><ref name="pmid7784946">{{cite journal |vauthors=Ruberto E, Espinola R, Brusco J, Bacchiocchi M, Zoppi J, Paz R |title=[Idiopathic myelofibrosis with extramedullary hematopoiesis foci in the skin and testicles. Report of a case] |language=Spanish; Castilian |journal=Sangre (Barc) |volume=40 |issue=2 |pages=157–60 |date=April 1995 |pmid=7784946 |doi= |url=}}</ref>
*[[Edema|Swelling]] at the [[lymph node]] site<ref name="pmid28011890">{{cite journal |vauthors=Panda A, Chandrashekhara SH, Nambirajan A, Mishra P |title=Idiopathic myelofibrosis with disseminated hepatosplenic, mesenteric, renal and pulmonary extramedullary haematopoeisis, portal hypertension and tuberculosis: initial presentation and 2 years follow-up |journal=BMJ Case Rep |volume=2016 |issue= |pages= |date=December 2016 |pmid=28011890 |doi=10.1136/bcr-2016-217854 |url=}}</ref><ref name="pmid28781273">{{cite journal |vauthors=Sakatoku K, Takeoka Y, Araki T, Miura A, Fujitani Y, Yamamura R, Miyagi Y, Senzaki H, Ohta K |title=Lymphocyte-depleted classical Hodgkin lymphoma accompanied by myelofibrosis |language=Japanese |journal=Rinsho Ketsueki |volume=58 |issue=7 |pages=772–775 |date=2017 |pmid=28781273 |doi=10.11406/rinketsu.58.772 |url=}}</ref><ref name="pmid30046414">{{cite journal |vauthors=Aljabry MS, Asiri S, Elsafi T, Elyamany G |title=Generalized lymphadenopathy secondary to isolated extramedullary hematopoiesis as an initial manifestation of primary myelofibrosis |journal=Hematol Rep |volume=10 |issue=2 |pages=7588 |date=May 2018 |pmid=30046414 |pmc=6036984 |doi=10.4081/hr.2018.7588 |url=}}</ref>
*[[Sleep disorder|Sleep disturbance]], [[irritability]], loss of concentration<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>


==References==
==References==
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Latest revision as of 23:01, 30 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]Sujit Routray, M.D. [3]

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:

Common Symptoms

Common symptoms of myelofibrosis include:

Less Common Symptoms

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.
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