Vanderbilt-Ingram Cancer Center

Myeloproliferative Disorders

Myeloproliferative disorders cause the bone marrow to make too many red blood cells, white blood cells or platelets.

The bone marrow normally makes blood stem cells (immature cells) that develop into mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell, which develops into a white blood cell.

Myeloproliferative disorders make too many blood stem cells that develop into one or more types of blood cells. As the number of extra blood cells rises, the disorders can get worse.

There are 6 types of chronic myeloproliferative disorders:

1. Chronic myelogenous leukemia
   
2. Polycythemia vera: Disease causing the blood thicken with too many red blood cells in the blood and bone marrow
3. Primary myelofibrosis (also called chronic idiopathic myelofibrosis): Chronic disease that replaces the bone marrow with fibrous tissue. Organs such as the liver and spleen begin to make blood; normally bone marrow does this.
4. Essential thrombocythemia: High number of thrombocytes, or platelets, in the blood
5. Chronic neutrophilic leukemia: Too many neutrophils (a type of white blood cell) in the blood
6. Chronic eosinophilic leukemia: Too many eosinophils (a type of white blood cell) in the bone marrow, blood and other tissues

Chronic myeloproliferative disorders sometimes become acute leukemia when too many abnormal white blood cells are made.

Diagnosis

These tests can help detect and diagnose myeloproliferative disorders:

• Physical exam and history
• Complete blood count (CBC) checks for the following:
    -Number of red blood cells and platelets
    -Number and type of white blood cells
    -Amount of hemoglobin (the protein that carries oxygen) in the red blood cells
    -Portion of the sample made up of red blood cells
• Peripheral blood smear: Blood is checked for blast (developing) cells, number and kind of white blood cells, number of platelets and shape changes of blood cells
• Bone marrow aspiration and biopsy: Removal of bone marrow, blood and a small piece of bone using a needle
• Cytogenetic analysis: Lab test used to see chromosomal changes from tissue cells

Symptoms

Symptoms of Juvenile Myelomonocytic Leukemia:

• Pale complexion
• Fever
• Infection
• Easy bleeding
• A cough
• Poor weight gain
• Skin rash
• Swollen lymph nodes

Symptoms of Chronic Myelomonocytic Leukemia:

• Fever
• Infection
• Fatigue
• Easy bruising or bleeding
• Pain or a feeling of fullness below the ribs

Symptoms of Atypical Chronic Myelogenous Leukemia:

• Easy bruising or bleeding
• Fatigue
• Shortness of breath
• Pale complexion
• Pinpoint-sized spots under the skin from bleeding
• Pain or a feeling of fullness below the ribs on the left side

Treatment

There are many treatment options available, including chemotherapy, radiation, blood transfusion therapy, surgery, biologic therapy and stem cell transplants.

Treatment options depend on:

• Whether the myeloprofilerative disorder occurred after chemotherapy for another disease
• Whether the myeloprofilerative disorder has gotten worse after treatment
• Patient’s age and general health

If you are diagnosed with any of these conditions, talk to your doctor about joining a clinical trial.

Risk Factors

• Previous chemotherapy treatment
• Genetic syndromes
• Smoking
• Being older than 60
• Being male

Related Links

Vanderbilt-Ingram Cancer Center
National Cancer Institute
American Cancer Society
The Leukemia & Lymphoma Society