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Myelofibrosis: Types, Symptoms & TreatmentLocations:||||||Home/Health Library/Diseases & Conditions/MyelofibrosisAdvertisementAdvertisementMyelofibrosisMyelofibrosis (MF) is a rare blood cancer where scar tissue forms in your bone marrow. It’s a type of myeloproliferative neoplasm, which means that your body makes too many abnormal blood cells. These cells can replace normal cells. Treatment goals mainly involve managing symptoms and conditions that arise, including anemia and an enlarged spleen.AdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyCare at Cleveland ClinicMyelofibrosis TreatmentFind a Doctor and SpecialistsMake an AppointmentContentsArrow DownContentsArrow DownWhat Is Myelofibrosis?Myelofibrosis (MF) is a blood cancer where scar tissue builds up in your bone marrow. This reduces its ability to make blood cells. Bone marrow is the soft, spongy tissue inside your bones. It makes stem cells that mature into red blood cells, white blood cells or platelets.AdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyWith MF, a change in the stem cell’s genes causes it to become a cancer cell that multiplies fast. The cancer causes inflammation that creates scar tissue. The damage makes it harder for your bone marrow to make healthy blood cells. Meanwhile, your spleen (which filters abnormal blood cells) becomes overworked. It can enlarge and cause symptoms.Myelofibrosis (pronounced “my-low-fi-BRO-sus”) is a lifelong condition that often progresses slowly. But sometimes, it gets worse fast. In some cases, it transforms into an aggressive type of acute leukemia. This is why your healthcare provider will manage your care closely once you’re diagnosed.Types of this conditionThere are two types of myelofibrosis:Primary myelofibrosis occurs on its own. It’s the most common type.Secondary myelofibrosis or Post-ET/PV MF occurs when essential thrombocythemia or polycythemia vera progresses. These conditions are myeloproliferative neoplasms (MPNs). MPNs are blood cancers where your bone marrow makes too many blood cells. Primary myelofibrosis is also an MPN.Symptoms and CausesSymptoms of myelofibrosisMyelofibrosis often gets worse slowly. You may not have symptoms for years. When symptoms do start, the first to show are usually severe fatigue (a sign of anemia) and an enlarged spleen. An enlarged spleen may feel like heaviness in your upper left abdomen. Or the area may hurt.AdvertisementOther signs and symptoms include:Bone and joint painEasy bruising or bleedingEnlarged liverFeverGetting infections easilyFeeling full when you haven’t eaten muchItchingNight sweatsProblems concentratingUnexplained weight lossMyelofibrosis causesPrimary myelofibrosis happens when the earliest form of a blood cell — a stem cell — transforms into a cancer cell. The cell makes malignant copies (clones) that build up in your bone marrow.The clones crowd out healthy blood cells. They also release substances that damage your bone marrow. The damage leads to scarring inside your bones.Doctors don’t know what causes this process in the first place. But they do know that many people with MF have common genetic mutations. A mutation is a change in a gene. The most common ones are:JAK2CALRMPLRisk factorsYou may be at increased risk of myelofibrosis if:You’re over 60You have primary thrombocytosis or polycythemia veraYou’ve been exposed to large doses of ionizing radiation (rare)You’ve been exposed to high levels of industrial chemicals like benzene (rare)Complications of this conditionAs myelofibrosis advances, it can lead to:Decreased blood cell production: The scar tissue can crowd out the normal cells in your bone marrow. This can lead to anemia or low platelets.Blood cell production outside of your bone marrow: Blood cells unable to form in your bone marrow may develop in your spleen, liver or other organs.High blood pressure in your portal vein: Your portal vein carries blood from your spleen to your liver. Tumors from the out-of-place blood cells can put too much pressure on this vein. This can cause serious bleeding.Acute myeloid leukemia (AML): MF can progress to AML. This is the most aggressive form of leukemia.Diagnosis and TestsHow doctors diagnose this conditionYour healthcare provider will do a physical exam and review your medical history. They’ll ask about your symptoms. Tests you may need include:Blood tests: They’ll check for abnormal blood cell counts and cells that look atypical. They’ll also check for levels in your blood that may mean an organ is stressed.Imaging tests: A CT scan or ultrasound can show if your spleen or liver is enlarged. An MRI can show scarring in your bone marrow.Bone marrow biopsy: A provider will analyze cells from your bone marrow to check for cancer. They’ll test for common gene mutations in MF.Staging and risk scoringAs part of your diagnosis, your healthcare provider may stage MF as either prefibrotic (early) or overt (advanced). Prefibrotic MF involves less scarring in your bone marrow than overt MF.Your provider may also score your MF. Scoring systems for MF consider your symptoms, test results and the type of mutation. The results range from low- to intermediate- to high-risk. This helps providers estimate your life expectancy after treatment.Low-risk MF typically requires less-intensive treatments than high-risk MF.Management and TreatmentHow is myelofibrosis treated?You don’t need treatment if you have low-risk MF and aren’t symptomatic. Instead, your healthcare provider will monitor you.AdvertisementCommon medications used to treat intermediate- and high-risk myelofibrosis include JAK inhibitors like:Fedratinib (Inrebic®)Momelotinib (Ojjaara®)Pacritinib (Vonjo®)Ruxolitinib (Jakafi®)For most people, the goal of treatment is to manage conditions that cause symptoms. Treatment may also slow disease progression.Anemia treatmentsTreatments that manage anemia include:Medications, including androgens, chemotherapy drugs, immunomodulators, corticosteroids and human-made forms of erythropoietin (medicines that aid red blood cell production)Blood transfusionsEnlarged spleen treatmentsTreatments for an enlarged spleen include:Medications, including chemotherapy drugs and immunomodulators or targeted therapy (like JAK inhibitors)Radiation therapy directed at your spleen (rarely)Surgery to remove your spleen (very rarely)Stem cell transplantA hematopoietic stem cell transplant (HCT) is a potential cure for MF. For some people, it’s not a cure, but it helps them live longer. Still, an HCT is a risky procedure with potentially fatal complications. It’s not an option for everyone. Instead, healthcare providers recommend it for people who are diagnosed as high risk.This procedure involves replacing abnormal stem cells with healthy cells from a donor.AdvertisementWhen should I see my healthcare provider?Your provider will monitor you regularly. In the meantime, let them know what symptoms you’re experiencing. Report any treatment-related side effects you have.Care at Cleveland ClinicMyelofibrosis TreatmentFind a Doctor and SpecialistsMake an AppointmentOutlook / PrognosisWhat is the life expectancy for someone with myelofibrosis?People with more advanced scarring in their bone marrow live about three to seven years after diagnosis. People with prefibrotic (early) MF live for about 10 to 15 years. About 20 out of every 100 people with primary MF develop acute myeloid leukemia within 10 years of their diagnosis.But it’s important to remember that your prognosis (outlook) depends on lots of things. Your stage, risk score, the type of genetic mutations you have — they’re just some of the factors that matter.Ask your provider about what your diagnosis means for your experience of the disease.Is there anything I can do to feel better?Ask your healthcare provider if you could benefit from palliative care. Palliative care specialists can help you navigate the challenges of a cancer diagnosis. Unlike hospice care, these providers can help people with chronic illnesses, no matter their prognosis.You can also ask your provider if you’re a candidate for a clinical trial. Clinical trials study the safety and effectiveness of new treatments. Doctors continue to discover new therapies that are improving the lives of people with MF.AdvertisementA note from Cleveland ClinicNo two experiences of myelofibrosis (MF) are the same. Depending on your situation, you may go several years with no symptoms. Or symptoms may progress fast, and you find yourself suddenly adjusting to new medications. Regardless, an MF diagnosis requires collaboration with your caregivers. Let your healthcare provider know the symptoms you’re experiencing. Report any side effects from treatment. This may be a chronic condition, but there are treatments that can improve your experience of this disease.Care at Cleveland ClinicIf you have a rare blood cancer like myelofibrosis, you want experts by your side. At Cleveland Clinic, we’re with you from testing to treatment and beyond.Myelofibrosis TreatmentFind a Doctor and SpecialistsMake an AppointmentMedically ReviewedLast reviewed on 06/27/2025.Learn more about the and our .ReferencesAdvertisementAdvertisementAdCancer Answer Line Rendered: Sat Jul 05 2025 05:59:28 GMT+0000 (Coordinated Universal Time)ActionsBlog, News & AppsAbout Cleveland ClinicSite Information & Policies9500 Euclid Avenue, Cleveland, Ohio 44195 | 800.223.2273 | © 2025 Cleveland Clinic. All Rights Reserved., Myelofibrosis is a rare blood cancer where scar tissue forms in your bone marrow. It’s a type of chronic leukemia that involves too many abnormal blood cells., Myelofibrosis causes scarring in the bone marrow. This makes it hard for the bone marrow to make healthy blood cells. Myelofibrosis sometimes happens on its own. This is called primary myelofibrosis. Sometimes it's caused by another blood cell condition. When this happens, it's called secondary myelofibrosis..
Primary myelofibrosis (also called chronic idiopathic myelofibrosis, agnogenic myeloid metaplasia) is a disorder in which normal bone marrow tissue is gradually replaced with a fibrous scar-like material. Over time, this leads to progressive bone marrow failure., The result is excessive fibrous (scar) tissue formation in the bone marrow, which can lead to severe anemia, weakness, fatigue and an enlarged spleen and liver. MF can occur on its own, called “primary myelofibrosis,” or as a progression of other bone marrow diseases., Chromosomes in bone marrow are examined to look for abnormalities in individual cells -- specifically the Philadelphia chromosome that is used in diagnosing CML., As scar tissue grows, the bone marrow loses its ability to make enough healthy blood cells. Myelofibrosis is considered to be a type of chronic leukemia, which affects blood-forming tissues. It, Bone marrow derived mesenchymal stem cells from chronic myeloid leukemia t (9;22) patients are devoid of Philadelphia chromosome and support cord blood stem cell expansion, Chronic myeloid leukemia is a slow-growing cancer of the blood-forming tissue (bone marrow). Normal bone marrow produces red blood cells (erythrocytes) that carry oxygen, white blood cells (leukocytes) that protect the body from infection, and platelets (thrombocytes) that are involved in blood clotting..