Science Today

Myelofibrosis, How much do you know about this type of blood cancer?

In the framework of World Cancer Day 2023 Let’s talk about cancer... fearless

More than three years after the COVID-19 pandemic (caused by the SARS-CoV-2 virus), much research has been done and continues to be done on this condition worldwide, especially on the sequelae that people who have already gone through the disease are presenting in the short, medium and long term. So many and indistinct that it seems that either we are getting used to it or we have stopped being afraid of the disease, especially now that it is not as lethal as at first.

It seems that fatigue, night sweats, bone, and joint pain are becoming part of our day-to-day to cope with them without the greatest problem, in the certainty that these symptoms, at least, will not kill us. However, there is no greater mistake – proven – than trusting or not giving importance to the “alarms” that the body is emitting through signs and symptoms, and that may well be the antecedent of something serious.

Did you know that if you feel pain or a feeling of fullness under your ribs on your left side, sweat at night, and constantly develop a fever, it could be an indication of a condition called myelofibrosis?

Myelofibrosis is a disease classified among hematological (blood) cancers that occur in bone marrow cells. It is a progressive condition that develops fibrous tissue that scars the bone marrow and has difficulty developing normal cells. It usually occurs in adults (over 60 years old), although currently a quarter of them are under that age and there are even some cases in young people.

Identifying a condition such as myelofibrosis can be difficult, however, there are signs and symptoms that may occur more frequently in patients, including 14:

1. Splenomegaly. About 85% of people living with myelofibrosis have this symptom identified as an enlarged spleen.

2. Weight loss. Most blood diseases can have weight loss for no apparent reason.

3. Fatigue and weakness. The decrease in red blood cells by the bone marrow causes the person to live with chronic fatigue.

4. Bleeding or bruising. The unexplained appearance of bruises (hematoma) or bleeding for no reason is another symptom of the disease.

5. Bone or joint pain. Bone pain is a common symptom in people who start with the disease.

6. Excessive sweating. The presence of excessive sweating is a sign of affectation, especially at night.

7. Neutropenia. People living with this type of neoplasm are more susceptible to infections, this condition is known as neutropenia.

8. Pruritus. In addition to the presence of bruising or hematoma, itchy skin is common in people living with myelofibrosis.

9. Anemia. As a result of low red blood cell production, this condition develops.

10. Thrombocytopenia. This condition occurs due to the low concentration of platelets (thrombocytes).

11. Hepatomegaly. Enlargement of the liver is one of the manifestations that can appear in people living with this carcinoma.

12. Petechiae. It is the appearance of red, flat dots on the skin that are caused by bleeding.

13. Palido. Paleness of the skin may be a reflection of anemia, which is common in people living with this type of malignant tumor.

14. Fever. Some patients may experience lowgrade fever, as a symptom of myelofibrosis.

About one-third of people living with myelofibrosis have no symptoms, so myelofibrosis becomes mistaken for cirrhosis or severe anemia. It is a disease that can take six months to three years to be diagnosed; when it evolves, the patient is very clinically impaired when diagnosed. The correct way to identify it is to perform frequent medical check-ups and general studies on the patient who presents one or more initial symptoms.

Given the panorama described above, it is worth performing a bone marrow study if you suspect having some type of cancer in the blood, especially if you have a history of the disease in the family.

Bone marrow is a soft, spongy tissue with many blood vessels located in the center of most bones. The main function of bone marrow is to maintain a normal number of these three types of cells, replacing the old ones with new cells.

There are two types of bone marrow: yellow and red, the red contains stem cells that transform into red, white blood cells, and platelets; while yellow is composed of fat and stem cells that become cartilage, fat, or bone cells.

Blood cells begin as stem cells and subsequently develop into:

*Platelets: create plugs that stop bleeding in the area of an injury.

*Red blood cells: carry oxygen to the body’s tissues.

*White blood cells: fight infections in the body. They are divided into neutrophils, macrophages and lymphocytes.

Among the diseases that affect the bone marrow, we find anemia, leukemias, myelofibrosis, myelodysplastic syndromes and lymphomas. Bone marrow is analyzed through two main studies: bone marrow biopsy and aspiration, to look at cells and also genetic components.

1.- Bone marrow aspiration: procedure used to extract the liquid part of the bone marrow.

2.- Bone marrow biopsy: a procedure by which a small solid sample of the bone marrow is obtained.

Both studies are performed simultaneously and usually the sample is taken from the pelvic bone, located in the lower back on one side of the hip.

The essential for diagnosis is the bone marrow biopsy, where a small sample of bone tissue of 1 cm is taken to send to a hematopathology laboratory, and through it, the degree of fibrosis inside the marrow is identified. The hematologist is responsible for performing these procedures to examine the cells. The pathologist will be the specialist who will interpret the results to identify a disease such as myelofibrosis.

Irene Licona

Journalist; Communicologist graduated from UNAM. Columnist in Encuentro Vital; Science communicator specialized in Cancer.