Myeloproliferative Disorders (MPDs) Causes, Symptoms, and Treatment Options
If you have MPD, you need a care team of blood cancer experts.
At the Mario Lemieux Center for Blood Cancers, we offer the latest treatment options that we'll tailor to your needs.
What Are Myeloproliferative Disorders (MPDs)?
MPDs are blood cancers caused by changes in the stem cells inside bone marrow, the tissue that makes blood cells.
These changes cause the body to make too many blood cells. This excess can be any type of blood cell — white, red, or platelets.
Your MPD diagnosis depends on which blood cell — or cells — your body overproduces.
MPDs usually affect only one type of blood cell. Rarely do they affect more than one.
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All MPDs have one thing in common: the bone marrow makes too many blood cells. Over time, these excess cells crowd out the healthy blood cells.
- Chronic eosinophilic leukemia. Too many white blood cells called eosinophils.
- Chronic myelogenous leukemia. Too many immature myeloid cells, which make most types of blood cells. This disease may progress into acute myeloid leukemia.
- Chronic neutrophilic leukemia. Too many white blood cells called neutrophils.
- Essential thrombocythemia. Too many platelets, the blood's clotting cells. This can lead to blood clots, increasing the risk of heart attack or stroke.
- Polycythemia vera. Too many red blood cells.
- Primary myelofibrosis (also called chronic idiopathic myelofibrosis). Too many collagen cells in the marrow. This leads to excessive scar tissue that can prevent the marrow from making enough healthy blood cells. The liver and spleen may start to make blood cells to compensate.
In most cases, doctors can't pinpoint a specific cause of MPDs.
Possible causes may include:
- Environment. Overexposure to radiation, electrical wiring, or chemicals.
- Genetics. Research has linked changes in the JAK2 and TET2 genes to an increased risk of polycythemia vera. Most people with CML also have the Philadelphia chromosome, a genetic change that breaks a gene.
The risk factors — age, environmental exposure, and gender — differ for each type of MPD.
Chronic myelogenous leukemia
- People between 45 and 50 are at higher risk.
- High radiation doses may increase risk.
- Men are at higher risk.
- People older than 60 are at risk, but 20% of cases occur in people under 40.
- Exposure to certain chemicals or electrical wiring may increase risk.
- Women are 1.5 times more likely to get this condition.
- People between 60 and 70 are at higher risk.
- Intense radiation exposure or exposure to benzene may increase risk.
- Men are slightly more at risk.
- People older than 60 are at greater risk.
- High radiation doses may increase risk.
- Men are twice as likely as women to get this condition.
Myeloproliferative Disorder Signs and Symptoms
MPDs are a group of somewhat similar diseases that share some common symptoms.
Dome people have few or no signs of an MPD in the early stages. The more abnormal your blood counts are, the more likely you are to have symptoms.
Common MPD symptoms include:
- Weakness and malaise.
- Shortness of breath.
- Loss of appetite.
- Pale skin.
- Belly pain.
- Feeling of fullness.
Moderate to severe anemia is common in MPDs in which other cells crowd out red blood cells.
Infections are common in MPDs in which other cells crowd out white blood cells. These can include sinus, skin, or urinary tract infections.
It's vital to see your doctor if you have any of these symptoms.
How Do Doctors Diagnose Myeloproliferative Disorders?
The first sign of an MPD is often an enlarged spleen that your doctor finds during an exam.
If you have an enlarged spleen, your doctor might order some tests to check for MPDs.
Blood tests will detect any problems with your blood cell and platelet numbers.
They can also detect infection, anemia, and leukemia.
Bone marrow sample
You might need a bone marrow biopsy if your blood tests find abnormalities.
Your doctor will remove a small sample of bone marrow and send it to the lab to test for cancer. Lab techs will view the cells under a microscope to look for chromosome changes seen in MPDs.
MPD Treatment Options
Doctors can't currently cure MPDs, but these diseases tend to develop over months or years. Treatment goals for MPDs are to improve symptoms and prevent complications.
Treatment for each MPD varies.
You may need surgery to remove an enlarged spleen.
CML treatments include targeted drugs, chemo, and immunotherapy.
You may also have a stem cell transplant followed by a donor lymphocyte infusion (DLI).
Treatment focuses on managing symptoms, such as:
- Vision problems.
- Trouble hearing.
Expect your doctor to watch for signs of heart attack or stroke caused by blood clots.
Medicine like hydroxyurea can improve symptoms and reduce the number of blood cells.
Cancer drugs like thalidomide and lenalidomide can also treat anemia and reduce symptoms.
Your doctor will draw blood to lower your red blood cell counts.
Drugs such as hydroxyurea may also reduce the number of blood cells. Low-dose aspirin and antihistamines can help control fevers and itching.
UPMC also offers clinical trials that test new treatments for MPDs. Talk to your doctor to learn if you qualify for a trial.
Myeloproliferative Disorder Prognosis
Many people live with an MPD for years with little or no effect on their quality of life.
Your long-term outlook depends on:
- The type of MPD you have.
- Your health.
- How well you respond to treatment.
About 20% of people with MPDs develop multiple myeloma.
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