blood disorders
Myelofibrosis
Treatment of Myelofibrosis
Sometimes stem cell transplantation Sometimesruxolitinib,fedratinib,momelotinib, orpacritinib Some people do not need treatment. For most people, treatment is given to reduce symptoms and complications. Stem Cell Transplantation None Ruxolitinib,a medication that was developed to inhibit theJAK2mutation is often the first treatment used. It is also effective in people who have theCALRorMPLmutations because they also activate JAK2 enzyme. It is effective in reducing spleen size and controlling symptoms and may increase overall survival and slow the rate of fibrosis, but it does not reverse existing fibrosis in most cases and can lead to anemia and low platelet counts.Fedratinib,pacritinib, andmomelotinibalso inhibit theJAK2mutation and can be used as alternatives toruxolitinib. Reducing the size of the spleentends to relieve symptoms. In addition toruxolitinib,hydroxyurea, a chemotherapy drug, may decrease the size of the liver or spleen but may worsen anemia and lower the platelet count. Radiation therapy can decrease the size of the spleen but has only a temporary effect and can cause very low white blood cell counts and infection. Rarely, the spleen becomes extremely large and painful and may have to be removed, but spleen removal is recommended only after all other measures have been tried. It is not done often in people with primary myelofibrosis due to potential complications such as blood clotting, infection, and shift of blood cell production to other vital organs such as the liver. to prevent enlargement of the spleen. Some people with severe anemia require Red blood cells . Doctors sometimes also givethalidomideorlenalidomidetogether withprednisone, which can help maintain the platelet count and also reduce the size of the spleen. Other medications are being developed to treat myelofibrosis, so people may want to search for a clinical trial. 