clinical features

Last reviewed 05/2021

Clinical features of myelofibrosis include:

  • majority of the patients are over age 60 years at the time of diagnosis  (1)
  • around 33% are asymptomatic at presentation (1)
  • progression is insidious - patients commonly present with fatigue and weakness due to anaemia; or because of abdominal fullness and early satiety due to splenomegaly
  • spleen is often massively enlarged -
    • is a characteristic finding (1)
    • seen in 90% of the patients at presentation (2)
    • can be massive in some patients (>10kg) (3)
    • symptoms include - pain, abdominal bloating, early satiety, difficulty with bending or routine activities or back pain due to altered centre of balance
    • splenic sequestration in splenomegaly may cause or exacerbate myelofibrosis associated cytopenias (3)
  • hepatomegaly occurs in over half of cases

With progressive fibrosis of bone marrow there may be:

  • severe anaemia - necessitating transfusion
  • bleeding - due to thrombocytopenia
  • respiratory pain - due to perisplenitis secondary to splenic infarction
  • severe bone pain, especially in the lower legs
  • hyperuricaemia and gout - from rapid blood cell turnover
  • cachexia

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