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Myeloproliferative Neoplasms

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Signs and Symptoms

The severity of an MPN varies from person to person. The condition may be acute and life-threatening or it may be very subtle, existing for years before being diagnosed, frequently discovered during a routine physical. While each condition has its own set of symptoms, some signs and symptoms are common to more than one. Examples include:

  • Unexplained weight loss
  • Weakness and fatigue
  • Enlarged spleen (splenomegaly) - cells accumulate in the spleen because it makes blood cells and because it filters old or abnormal cells out of the bloodstream; this causes the spleen to swell, which can cause abdominal discomfort.
  • Excessive bleeding and easy bruising, due to insufficient and/or abnormal platelets
  • Night sweats
  • Bone and joint pain
  • Pallor (pale complexion) due to anemia (when red blood cells are decreased)
  • Frequent infections
  • Headache, dizziness, numbness and/or problems with vision

In someone with polycythemia vera, the excess number of RBCs produced increases the thickness (viscosity) of the blood. This can cause symptoms such as headaches, dizziness, visual distortion, itching, and numbness or tingling (paresthesia). Sometimes the excessive RBCs may lead to complications, such as stomach ulcers, kidney stones, venous thrombosis, stroke, and rarely to congestive heart failure.

In people with polycythemia vera or primary thrombocythemia, especially if they are older than 60, their disease may progress to myelofibrosis. In myelofibrosis, fibrous scar tissue replaces bone marrow, similar to what is seen with primary myelofibrosis. Myelofibrosis often causes no symptoms early in the course of the disease; about one-third of those who are diagnosed are asymptomatic. People who do have symptoms may experience fatigue, shortness of breath, and enlargement of the spleen. Fibrous tissue eventually fills the bone marrow, reducing the production of all blood cells. Anemia may become severe.

Most people with essential thrombocythemia are asymptomatic, but some develop a blood clot (thrombosis) or experience excessive bleeding because of increased numbers of platelets that do not function properly. They also may have tingling in the hands and feet, headaches, chest pain or discomfort, bloating in the upper left abdominal area, weakness, dizziness, nosebleeds, and easy bruising.

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