Myelofibrosis Treatment: Risk factors, Symptoms, Causes & Doctors in India

Myelofibrosis is a life-threatening bone marrow disorder that disrupts the body’s normal production of blood cells. The disease causes inflammation that leads to scars (fibrosis) in the bone marrow.  Many people with MF get progressively worse, and some may eventually develop a more serious form of leukemia, however, it is possible to have MF and live symptom-free for years.

What Causes Myelofibrosis?

MF occurs when blood stem cells – cells that can divide into multiple specialized cells that make up our blood viz. red blood cells, white blood cells and, platelets – develop a genetic mutation for reasons unknown to medical science. As the mutated blood cells replicate and divide, the mutation is passed along to the new cells with serious effects on blood production. This usually results in a lack of red blood cells – which causes the anemia characteristic of MF – and an overabundance of white blood cells with varying platelet levels.

What are the risk factors?

Although the exact cause of MF is not known, there are certain factors that increase the risk of acquiring the disease:

  • AGE: Most often diagnosed in people older than 50.
  • ANOTHER BLOOD CELL DISORDER: Some people with MF develop the condition as a complication of essential thrombocythemia or polycythemia vera.
  • EXPOSURE TO CERTAIN CHEMICALS: MF has been linked to exposure to industrial chemicals such as toluene and benzene.


Symptoms of Myelofibrosis?

MF usually develops slowly and in its early stages, many people don’t experience any signs or symptoms, however, as disruption of normal blood cell production increases, the signs and symptoms may include:

  • Feeling tired, weak or short of breath, usually because of anemia
  • Pain or fullness below the ribs on the left side, due to an enlarged spleen
  • Easy bruising
  • Easy bleeding
  • Excessive night sweats
  • Fever
  • Bone pain

What complications may result from Myelofibrosis?

The complications that result from MF may include: 

INCREASED PRESSURE ON THE BLOOD FLOWING INTO THE LIVER: Normally, blood flow from the spleen enters the liver through a large blood vessel called the portal vein. Increased blood flow from an enlarged spleen can lead to high blood pressure in the portal vein forcing excess blood into smaller veins in the stomach and esophagus, potentially causing these veins to rupture and bleed.

  • PAIN: A severely enlarged spleen can cause abdominal pain and back pain. 
  • GROWTHS IN OTHER AREAS OF THE BODY: Formation of blood cells outside the bone marrow may create clumps or tumors of developing blood cells in other areas of the body. These tumours may cause bleeding in the gastrointestinal system, coughing or spitting up of blood, compression of the spinal cord, or seizures. 
  • BLEEDING COMPLICATIONS: As the disease progresses, the platelet count tends to drop below normal (thrombocytopenia) and platelet function becomes impaired – easy bleeding. 
  • PAINFUL BONES & JOINTS: MF can lead to hardening of the bone marrow and inflammation of the connective tissue around the bones causing bone & joint pain. 
  • ACUTE LEUKAEMIA: Some people with MF eventually develop acute myelogenous leukemia (AML) – a type of blood and bone marrow cancer that progresses rapidly.

How is Myelofibrosis Diagnosed? 

The various tests and procedures used to diagnose MF include: 

  • PHYSICAL EXAM: Check of vital signs, such as pulse and blood pressure, as well as checks of your lymph nodes, spleen, and abdomen. 
  • BLOOD TESTS: In MF, a complete blood count (CBC) typically shows abnormally low levels of red blood cells, a sign of anemia common in people with MF. White blood cell and platelet counts are usually abnormal too. 
  • IMAGING TESTS: X-rays and magnetic resonance imaging (MRI) may be used to gather more information about the condition. 
  • BONE MARROW EXAMINATION: A bone marrow biopsy and aspiration can confirm a diagnosis of MF. 
  • GENE TESTS: A sample of the blood or bone marrow may be analyzed in a lab to look for gene mutations in the blood cells. 

What is the Treatment Procedure?

There is no single treatment that is effective for all MF sufferers. Each patient has a unique set of symptoms and circumstances that require different treatment options. Some patients with MF remain symptom-free for many years and may not require immediate treatment, however, it is essential that an MF patient is monitored over time for signs or symptoms

The Available Treatments & Therapies for MF include: 

  • TREATMENTS THAT TARGET GENE MUTATIONS: Researchers are working to develop medications that target the gene mutation (JAK2) that’s believed to be responsible for MF. One of these medications, Ruxolitinib, has been helpful in decreasing enlarged spleens and reducing symptoms associated with MF. 
  • ALLOGENIC STEM CELL TRANSPLANT (ASCT): ASCT, where the stem cells are transferred from a donor to a patient, is the only curative treatment for MF OTHER SYMPTOM-SPECIFIC TREATMENTS

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Dr. Vikas Dua

Head and Senior Consultant, Pediatric Hematology Oncology, and Bone Marrow Transplant

Dr. Vikas Dua is Paediatric Hemato Oncologist and bone marrow transplant specialist of the generation. Dr. Dua's results in the field of Paediatric Haematology Oncology and BMT have been some of the best. He and his team has done 200 + paediatric transplants. 

About Dr. Rahul Bhargava

Hematologist, Hemato-oncologist & Stem Cell Transplant Physician

With over 20 years of experience, Dr. Rahul Bhargava is currently the Director of Haematology, Paediatric Haematology, Immunology and Stem Cell Transplant at Fortis Memorial Research Institute (FMRI), Gurgaon – India’s first integrated Centre of Excellence in Haematology, Paediatric Haematology, and Stem Cell Transplant.

Dr. Aniruddha Dayama

Hematology, Pediatric Oncology & Bone Marrow Transplant Specialist

Dr. Aniruddha Dayama in 2015 led the efforts to get NMDP, USA approval for one of the leading hospitals in Gurgaon. He and his team have popularised autologous transplants in multiple sclerosis. The team has been credited for establishing six low-cost centers across North India.