Myeloproliferative Neoplasms (MPNs)

When choosing a treatment center for a myeloproliferative neoplasm (MPN), you want a team of experienced and compassionate experts. The team at Dana-Farber Brigham Cancer Center has extensive experience caring for patients with MPNs. Patients with MPNs are cared for by expert oncologists in our Adult Leukemia Program.

Exceptional Care for MPN Patients

• A highly specialized program focusing on MPN diagnostics, treatment, and research
• Access to clinical trials exploring new treatments, based on promising scientific discoveries
• Consultations and second opinions for patients and physicians nationally and internationally
• Access to the latest diagnostics, such as molecular and genomic profiling, including the Rapid Heme Panel, available only to patients at our center
• Collaboration with our internationally recognized bone marrow/stem cell transplantation program, if appropriate
• The full expertise of two renowned medical centers: Dana-Farber Cancer Institute and Brigham and Women's Hospital
• Care plans tailored to the needs of each patient, from the first meeting through long-term monitoring
• Access to support programs such as nutrition services, social work support, integrative therapies, and survivorship programs

What Are Myeloproliferative Neoplasms?

Myeloproliferative neoplasms (MPNs) are a group of blood disorders that occur when the bone marrow makes too many red blood cells, white blood cells, or platelets. There are different types of MPNs, depending on what type of cell is produced in a greater amount. The most common forms are:

• Polycythemia vera: Polycythemia vera occurs when the body creates too many red blood cells. This causes the blood to thicken, which can lead to health problems such as stroke, heart attack, or tissue or organ damage.
• Essential thrombocytosis: This disorder occurs when the body produces too many platelets, causing abnormal blood clotting or bleeding.
• Myelofibrosis: Myelofibrosis is caused by the buildup of fibrous tissue in the bone marrow. The fibers become thick and affect the bone marrow's ability to make healthy blood cells.
• MDS/MPN overlap: In MDS/MPN overlap disorders, individuals have a blood disorder with characteristics of both myelodysplastic syndromes (MDS) and MPNs. There are 4 subtypes of MDS/MPN overlap disorders:
  • Chronic myelomonocytic leukemia (CMML)
  • Atypical chronic myelogenous leukemia (aCML)
  • MDS/MPN overlap with ring sideroblasts and thrombosis (MDS/MPN RS-T)
  • MDS/MPN unclassified
• Systemic Mastocytosis: This disorder is caused when the body makes too many mast cells, a type of immune cell.

Incidence

Myeloproliferative neoplasms are rare blood disorders. Approximately 20,000 new cases are diagnosed in the U.S. each year. MPNs generally develop after age 50. They are chronic conditions that individuals can manage and live with for a long time if treated properly. However, some can be more aggressive and develop into an acute leukemia.

Risk Factors

Some patients with MPNs have no known risk factors for developing the disease. Some recognized risk factors are:

• Being older (50 years or more)
• Exposure to high levels of radiation
• Long-term exposure to certain environmental or industrial chemicals
• Mutations in JAK protein or CALR gene are shown to be associated with MPNs

Signs and Symptoms of MPNs

Most individuals usually do not experience many symptoms before an MPN diagnosis. Some general symptoms may include:

• Extreme fatigue
• Easy bruising or bleeding
• Weight loss
• Night sweats
• Fever
• Headache
• Itching
• Feeling full quickly, caused by having an enlarged spleen

Symptoms usually develop over time and get worse if the MPN is not treated.

These symptoms can have many causes and may not be due to cancer. However, it is important that you discuss persistent symptoms with your primary care doctor.

Growth and Spread

MPNs are chronic conditions, which means most individuals live for a long time with these disorders if they are treated properly. Rarely, some patients' diseases may develop to a more aggressive disease. Essential thrombocytosis and polycythemia vera may develop into myelofibrosis, acute leukemia, or MDS. Myelofibrosis may develop into acute myeloid leukemia. It is important to obtain an accurate diagnosis and treatment to manage these disorders.