Myeloproliferative disorders is the name for a group of conditions that cause blood cells, platelets, white blood cells, and red blood cells, to grow abnormally in the bone marrow. Though myeloproliferative disorders are serious, and may pose certain health risks, people with these conditions often live for many years after diagnosis. The prognosis largely depends on the type of disorder.
Myeloproliferative disorders include:
Signs and Symptoms
Many people with myeloproliferative disorders have no symptoms when their doctors first make the diagnosis. One symptom shared by all myeloproliferative disorders, with the exception of essential thrombocytosis, is an enlarged spleen. An enlarged spleen can cause abdominal pain and a feeling of fullness.
Some signs and symptoms of the different types of myeloproliferative disorders include:
Chronic myelogenous leukemia (CML)
All myeloproliferative disorders are caused by overproduction of one or more types of cells. No one knows what triggers the overproduction of cells, but theories include:
These factors may increase your risk for developing a myeloproliferative disorder:
Chronic myelogenous leukemia (CML)
A sign shared by all myeloproliferative disorders, with the exception of essential thrombocytosis, is an enlarged spleen. Your doctor may detect an enlarged spleen during a routine physical examination. In addition to doing a physical exam, the doctor may also conduct the following tests:
There is no cure for most myeloproliferative disorders. There are, however, several treatments that help improve symptoms and prevent complications associated with the conditions.
The treatment for each type of myeloproliferative disorder is slightly different:
A person's diagnosis and symptoms will determine the type of medication prescribed. Some possible medications include:
Chronic myelogenous leukemia (CML)
Recently, preliminary studies have suggested that two agents, imitinib and dasatinib, are effective treatments for CML.
Surgery and Other Procedures
With primary myelofibrosis, CML, and late stage polycythemia vera, blood cells are produced in sites other than the bone marrow, such as the liver and spleen. That causes these organs to get bigger. When enlargement of the spleen becomes painful, the person may have surgery to remove it.
In very serious cases of primary myelofibrosis, the person may undergo a stem cell transplant. In this procedure, abnormal stem cells (cells that manufacture blood cells) in the bone marrow are replaced with healthy stem cells. A stem cell transplant has life-threatening risks, however. In one study, 5-year survival was 62% in people younger than 45 years and 14% in those that were older.
For people with CML, a bone marrow transplant may be an option. After either a stem cell or bone marrow transplant, the healthy bone marrow cells begin to grow and produce healthy blood cells.
Phlebotomy, removing some blood from the body, may lower the risk of stroke in people with polycythemia vera. It is the primary therapy in polycythemia vera, and it's the only treatment that has improved survival. People with anemia may need blood transfusions. In one study, researchers suggest that low dose aspirin (81 to 325 mg/day) may lower the risk of blood clots in people with polycythemia vera.
Nutrition and Dietary Supplements
A treatment plan for myeloproliferative disorders may include a range of complementary and alternative therapies. Ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan. Always tell your doctor about the herbs and supplements you are using or considering using, as some supplements may interfere with conventional cancer treatments.
Myeloproliferative disorders need conventional medical treatment. There are not any supplements that can specifically help with these conditions. However, following a healthy diet and getting regular exercise may help to keep your body strong while coping with a myeloproliferative disorder. Try these tips:
Ask your doctor if you would benefit from the following supplements:
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
If you are undergoing treatment for cancer, you should always ask your doctor before taking any herbs or supplements. No herbs have been studied specifically for myeloproliferative disorders, but the following herbs may help your general health:
Pregnant women should avoid the drug hydroxyurea because it may pose a risk to the baby.
Prognosis and Complications
Myeloproliferative disorders are slow acting, and don't always cause life-threatening symptoms. The complications of these conditions, however, may be serious. Some complications include:
The survival rate for myeloproliferative disorders varies, depending on both the type of disorder and the kind of symptoms each person experiences.
Abraham S, Salama M, Hancock J, Jacobsen J, Fluchel M. Congenital and childhood myeloproliferative disorders with eosinophilia responsive to imatinib. Pediatr Blood Cancer. 2012;59(5):928-9.
Bauer JD, Capra S. Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy -- a pilot study. Support Care Cancer. 2005;13(4):270-4.
Bell DR, Gochenaur K. Direct vasoactive and vasoprotective properties of anthocyanin-rich extracts. J Appl Physiol. 2006;100(4):1164-70.
Bruchova H, Merkerova M, Prchal JT. Aberrant expression of microRNA in polycythemia vera. Haematologica. 2008;93(7):1009-16.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.
Chen F, Li L, Ma D, et al. Imatinib achieved complete cytogenetic response in a CML patient received 32-year indirubin and its derivative treatment. Leuk Res. 2010 Feb;34(2):e75-7.
de Lacerda JF, Oliveira SN, Ferro JM. Chronic myeloproliferative diseases. Handb Clin Neurol. 2014;120:1073-81.
De Stefano V, et al. Recurrent thrombosis in patients with polycythemia vera and essential thrombocythemia: incidence, risk factors, and effect of treatments. Haematologica. 2008;93(3):372-80.
Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-75.
Finazzi G, Barbui T. Evidence and expertise in the management of polycythemia vera and essential thrombocythemia. Leukemia. 2008;22(8):1494-502.
Fontani G, Corradeschi F, Felici A, et al. Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 2005;35(11):691-9.
Giovanni B, Michelle E, Letizia C, et al. Thalidomide in myelofibrosis with myeloid metaplasia: a pooled-analysis of individual patient data from five studies. Leuk Lymphoma. 2002;43(12):2301-7.
Goldman L, Ausiello DA, et al, eds. Cecil Textbook of Medicine. 23st ed. Vol 1. Philadelphia, PA: W.B. Saunders Company; 2007.
Kimura K, Ozeki M, Juneja LR, Ohira H. l-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2006 Aug 21.
Marchetti M, Barosi G, Balestri F, et al. Low-dose thalidomide ameliorates cytopenias and splenomegaly in myelofibrosis with myeloid metaplasia: a phase II trial. J Clin Oncol. 2004;22(3):424-31.
Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47.
Tefferi A. Abeloff: Abeloff's Clinical Oncology. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2008:106.
Tefferi A. Myelofibrosis with myeloid metaplasia. Med Prog. 2000;342(17):1255-65.
Tefferi A, Cortes J, Verstovsek S, et al. Lenalidomide therapy in myelofibrosis with myeloid metaplasia. Blood. 2006;108(4):1158-64.
Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.
Xiao Z, Hao Y, Liu B, Qian L. Indirubin and meisoindigo in the treatment of chronic myelogenous leukemia in China. Leuk.Lymphoma. 2002;43:1763-8.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.
Review Date: 2/2/2016
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.