In polycythemia vera, the blood becomes thickened with too many red blood cells. The number of white blood cells and platelets may also increase. These extra blood cells may collect in the spleen and cause it to swell. The increased number of red blood cells, white blood cells, or platelets in the blood can cause bleeding problems and make clots form in blood vessels. This can increase the risk of strokeor heart attack. In patients who are older than 65 years or who have a history of blood clots, the risk of stroke or heart attack is higher. Patients also have an increased risk of acute myeloid leukemia orprimary myelofibrosis.
Possible signs of polycythemia vera include headaches and a feeling of fullness below the ribs on the left side.
Polycythemia vera often does not cause early symptoms. It is sometimes found during a routine blood test. Symptoms may occur as the number of blood cells increases. Other conditions may cause the same symptoms. Check with your doctor if you have any of the following problems:
- A feeling of pressure or fullness below the ribs on the left side.
- Headaches.
- Double vision or seeing dark or blind spots that come and go.
- Itching all over the body, especially after being in warm or hot water.
- Reddened face that looks like a blush or sunburn.
- Weakness.
- Dizziness.
- Weight loss for no known reason.
In addition to a complete blood count, bone marrow aspiration and biopsy, and cytogenetic analysis, aserum erythropoietin test is used to diagnose polycythemia vera. In this test, a sample of blood is checked for the level of erythropoietin (a hormone that stimulates new red blood cells to be made
Primary myelofibrosis is a disease in which abnormal blood cells and fibers build up inside the bone marrow.
The bone marrow is made of tissues that make blood cells (red blood cells, white blood cells, andplatelets) and a web of fibers that support the blood-forming tissues. In primary myelofibrosis (also called chronic idiopathic myelofibrosis), large numbers of blood stem cells become blood cells that do not mature properly (blasts). The web of fibers inside the bone marrow also becomes very thick (likescar tissue) and slows the blood-forming tissue’s ability to make blood cells. This causes the blood-forming tissues to make fewer and fewer blood cells. In order to make up for the low number of blood cells made in the bone marrow, the liver and spleen begin to make the blood cells.
Possible signs of primary myelofibrosis include pain below the ribs on the left side and feeling very tired.
Primary myelofibrosis often does not cause early symptoms. It is sometimes found during a routineblood test. The following symptoms may be caused by primary myelofibrosis or by other conditions. Check with your doctor if you have any of the following problems:
- Feeling pain or fullness below the ribs on the left side.
- Feeling full sooner than normal when eating.
- Feeling very tired.
- Shortness of breath.
- Easy bruising or bleeding.
- Petechiae (flat, red, pinpoint spots under the skin that are caused by bleeding).
- Fever.
- Night sweats.
- Weight loss.
Certain factors affect prognosis (chance of recovery) and treatment options for primary myelofibrosis.
- The age of the patient.
- The number of abnormal red blood cells and white blood cells.
- The number of blasts in the blood.
- Whether there are certain changes in the chromosomes.
- Whether the patient has symptoms such as fever, night sweats, or weight loss.
Essential thrombocythemia is a disease in which too many platelets are made in the bone marrow.
Essential thrombocythemia causes an abnormal increase in the number of platelets made in the bloodand bone marrow.Patients with essential thrombocythemia may have no symptoms.
Essential thrombocythemia often does not cause early symptoms. It is sometimes found during a routine blood test. The following symptoms may be caused by essential thrombocytopenia or by otherconditions. Check with your doctor if you have any of the following problems:- Headache.
- Burning or tingling in the hands or feet.
- Redness and warmth of the hands or feet.
- Vision or hearing problems.
Platelets are sticky. When there are too many platelets, they may clump together and make it hard for the blood to flow. Clots may form in blood vessels and there may also be increased bleeding. These can cause serious health problems such as stroke or heart attack.Certain factors affect prognosis (chance of recovery) and treatment options for essential thrombocythemia.
- The age of the patient.
- Whether the patient has symptoms or other problems related to essential thrombocythemia.
- Chronic neutrophilic leukemia is a disease in which too many blood stem cells become a type of white blood cell called neutrophils. Neutrophils are infection -fighting blood cells that surround and destroy dead cells and foreign substances (such as bacteria). The spleen and liver may swell because of the extra neutrophils. Chronic neutrophilic leukemia may stay the same or it may progress quickly to acute leukemia.
Chronic eosinophilic leukemia is a disease in which too many white blood cells (eosinophils) are made in the bone marrow.
Eosinophils are white blood cells that react to allergens (substances that cause an allergic response) and help fight infections caused by certain parasites. In chronic eosinophilic leukemia, there are too many eosinophils in the blood, bone marrow, and other tissues. Chronic eosinophilic leukemia may stay the same for many years or it may progress quickly to acute leukemia.Possible signs of chronic eosinophilic leukemia include fever and feeling very tired.
Chronic eosinophilic leukemia may not cause early symptoms. It is sometimes found during a routineblood test. The following symptoms may be caused by chronic eosinophilic leukemia or by otherconditions. Check with your doctor if you have any of the following problems:
There is no standard staging system for chronic myeloproliferative neoplasms.
Staging is the process used to find out how far the cancer has spread. There is no standard staging system for chronic myeloproliferative neoplasms. Treatment is based on the type of myeloproliferative neoplasm the patient has. It is important to know the type in order to plan treatmenTreatment Option Overview
Key Points for This Section
- There are different types of treatment for patients with chronic myeloproliferative neoplasms.
- Eleven types of standard treatment are used:
- New types of treatment are being tested in clinical trials.
- Patients may want to think about taking part in a clinical trial.
- Patients can enter clinical trials before, during, or after starting their cancer treatment.
- Follow-up tests may be needed.
There are different types of treatment for patients with chronic myeloproliferative neoplasms.
Different types of treatments are available for patients with chronic myeloproliferative neoplasms. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.Eleven types of standard treatment are used:
Watchful waiting
Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptomsappear or change.Phlebotomy
Phlebotomy is a procedure in which blood is taken from a vein. A sample of blood may be taken for tests such as a CBC or blood chemistry. Sometimes phlebotomy is used as a treatment and blood is taken from the body to remove extra red blood cells. Phlebotomy is used in this way to treat some chronic myeloproliferative neoplasms.Platelet apheresis
Platelet apheresis is a treatment that uses a special machine to remove platelets from the blood. Blood is taken from the patient and put through a blood cell separator where the platelets are removed. The rest of the blood is then returned to the patient’s bloodstream.Transfusion therapy
Transfusion therapy (blood transfusion) is a method of giving red blood cells, white blood cells, or platelets to replace blood cells destroyed by disease or cancer treatment.Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into avein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.See Drugs Approved for Myeloproliferative Neoplasms for more information.Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.Radiation therapy to treat myeloproliferative neoplasms is usually directed at the spleen.Other drug therapy
Prednisone and danazol are drugs that may be used to treat anemia in patients with primary myelofibrosis.Anagrelide therapy is used to reduce the risk of blood clots in patients who have too many platelets in their blood. Low-dose aspirin may also be used to reduce the risk of blood clots.Thalidomide, lenalidomide, and pomalidomide are drugs that prevent blood vessels from growing into areas of tumor cells.See Drugs Approved for Myeloproliferative Neoplasms for more information.Surgery
Splenectomy (surgery to remove the spleen) may be done if the spleen is enlarged.Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight cancer or other diseases. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against disease. This type of treatment is also called biotherapy or immunotherapy.Interferon alfa and pegylated interferon alpha are biologic agents commonly used to treat some chronic myeloproliferative neoplasms.Erythropoietic growth factors are also biologic agents. They are used to stimulate the bone marrow to make red blood cells.Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Tyrosine kinase inhibitors are targeted therapy drugs that block signals needed for tumors to grow.Ruxolitinib is a tyrosine kinase inhibitor used to treat certain types of myelofibrosis.See Drugs Approved for Myeloproliferative Neoplasms for more information.Other types of targeted therapies are being studied in clinical trials.High-dose chemotherapy with stem cell transplant
High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
New types of treatment are being tested in clinical trials.
Information about clinical trials is available from the NCI Web site.Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Back to Top
No comments:
Post a Comment