Myelofibrosis belongs to a group of rare diseases called myeloproliferative neoplasms, which are types of blood cancer in which a person’s bone marrow produces too many blast cells. Myeloproliferative neoplasms have the capacity to progress to acute myeloid leukemia (AML).
This article explains what experts know about the progression of myelofibrosis to AML. It also gives an overview of both conditions, including their treatment options and the outlook for people living with them.
The name of the myeloproliferative disorder is based on the type of cell involved. According to the NCI, myeloproliferative neoplasms include:
- Myelofibrosis: The bone marrow forms abnormal blood cells and fibrous tissues.
- Chronic myeloid leukemia: The bone marrow produces too many white blood cells.
- Polycythemia vera: The bone marrow produces too many red blood cells.
- Essential thrombocythemia: The bone marrow forms too many platelets.
Myeloproliferative neoplasms can, in general, progress to AML. As a
AML will occur in about
Myelofibrosis vs. polycythemia vera diagnosis
Myelofibrosis is just one type of myeloproliferative neoplasm that can progress to AML. Doctors must distinguish it from a condition called polycythemia vera, which myelofibrosis
Leukemia is the umbrella term for blood cancers involving the white blood cells. There are four main types of leukemia:
- acute lymphocytic leukemia
- acute myeloid leukemia
- chronic lymphocytic leukemia
- chronic myeloid leukemia
Two different factors distinguish these leukemia types:
- Chronic vs. acute leukemia: With acute leukemia, the bone marrow produces too many abnormal white blood cells. These are either
myeloid blasts or lymphoid blasts. These cells multiply quickly and crowd out healthy bone marrow cells. In contrast, the bone marrow of a person with chronic leukemia produces too many mature and functional cells.
- Myeloid vs. lymphocytic leukemia: Myeloid leukemia involves myeloid cells, such as monocytes, neutrophils, and macrophages. Lymphocytic leukemia affects lymphoid cells, such as T cells and B cells.
AML is the most common form of leukemia, accounting for close to
Factors associated with progression
Knowing the likely outcome of myelofibrosis helps determine the most appropriate type and timing of treatment. Healthcare professionals use specific scoring systems for estimating a person’s outlook. According to the
- being 65 years of age or older
- having less than 10 grams of hemoglobin per deciliter of blood
- having more than 25,000 white blood cells per microliter of blood
- blast cells representing at least 1% of the cells in circulation (peripheral blood, not bone marrow)
- the presence of fatigue, anemia, or other signs and symptoms of myelofibrosis
DIPSS-independent risk factors include the presence of specific genetic changes in the myeloid blast cells, the person’s need for red blood cell transfusion, and low platelet count.
Many different treatment options can help reduce the chances of myelofibrosis progressing to leukemia. The
As with any form of treatment, the most appropriate option will depend on the individual. A
- night sweats
- unintentional weight loss
- fullness or discomfort in the abdomen
- quickly feeling full
- blood in the urine
- gastrointestinal bleeding
- pain in the bones
Should myelofibrosis progress to AML, a person may also experience some
Although doctors can cure AML in about
- the person’s physical ability to tolerate potentially curative treatment
genetic traitsof the cancer cells themselves
- the lack of a clear decision-making process in the treatment of AML in older age groups
Myelofibrosis can progress to AML, which is a very severe condition, through a complex process of genetic mutation. Some treatments can reduce the chances of myelofibrosis progressing to AML.
Several factors will determine the outlook of people with these conditions, including age, symptom severity, and the effectiveness of treatment.