Myelo­proliferative Neoplasms

When you have an MPN, your body makes too many red or white blood cells or platelets — or a combination of them — in your bone marrow (spongy tissue inside your bones). It’s often a chronic (long-term) blood cancer that needs to be managed with regular treatment and follow-up.

There are different kinds of myeloproliferative neoplasms:

• Polycythemia vera.
• Myelofibrosis.
• Essential thrombocythemia.
• Hypereosinophilic syndrome (chronic eosinophilic leukemia or CEL).
• Chronic myelogenous leukemia (CML).
• Chronic neutrophilic leukemia (CNL).
• Myeloproliferative neoplasm, unclassifiable (MPN-U).

You may have a myeloproliferative neoplasm for months or years before symptoms appear. Often, you’ll learn you may have an MPN during routine blood tests or a physical exam. If symptoms do show up, they can be similar to ones from other health conditions. You may have:

• Abnormally high or low blood counts (number of blood cells).
• Bleeding problems like nosebleeds or cuts that won’t stop bleeding.
• Blood clots that aren’t related to another underlying disease.
• Unexplained fatigue, weight loss, fever, bruising and other lingering symptoms.
• An enlarged spleen (splenomegaly).
• An enlarged liver (hepatomegaly).

If your primary care provider suspects you may have a blood condition, they’ll recommend a specialist to confirm a diagnosis and start treatment. At Cleveland Clinic, we use the latest testing to help you get expert, personalized treatment.

What to expect at your first visit

Hearing you may have blood cancer can be stressful. So can a visit to a specialist and waiting for test results. We understand this and do everything we can to ease your fears, make you comfortable and help you understand what’s going on.

That’s why your provider will start your appointment by getting to know you. So they’ll ask you to share your story. Understanding how you’ve been feeling is an important part of making a diagnosis. They’ll want to know:

• How long have you been feeling this way?
• What kind of symptoms do you have?
• Are your symptoms getting worse?
• Have you had any testing before this visit?
• Have you been diagnosed with other health conditions?
• What health conditions do family members have/have family members had?

Your provider will also do a physical exam to check your overall health. And they’ll look for signs of a myeloproliferative neoplasm. They’ll also order tests to help them rule out other conditions and confirm a diagnosis.

Testing for myeloproliferative neoplasms

There are many tests we can do to help us make a correct diagnosis. We check your blood, do genetic testing and see how well your organs are working. All of this can help us better understand what’s going on in your body. You may have one or all of these tests, including:

• Complete blood count (CBC).
• Peripheral blood smear (PBS).
• Bone marrow aspiration.
• Bone marrow biopsy.
• Kidney function tests.
• Liver function tests.
• Metabolic panels.
• Genetic testing.
• Karyotype test.

Second opinions for myeloproliferative neoplasms

A blood cancer diagnosis can be a real shock. You might feel anxious, worried and overwhelmed. But it’s also important you feel confident you have a care team that listens to your concerns, answers your questions and gives you the best possible care and treatment results. That’s why we encourage second opinions. 

We have a team dedicated to diagnosing and treating rare blood cancers like myeloproliferative neoplasms. These providers take the time to answer questions, explain treatment options and offer their expertise. And because we know that cancer doesn’t wait, we try to schedule your appointment as soon as possible. A second opinion can give you peace of mind knowing that you’re in the most capable, compassionate hands. 

Meet Our Myeloproliferative Neoplasms Team

We know that a blood cancer diagnosis can affect you in many ways — physically, mentally and emotionally. When you come to Cleveland Clinic, you’ll benefit from our team-based approach to care. 

This means you’ll have all the providers you need, from different specialties, planning and managing your care based on your needs. This team stays with you throughout your journey. Our hematologists lead this team, which could also include:

• Oncologists.
• Pathologists.
• Nurse practitioners.
• Phlebotomists. 
• Psychologists.
• Social workers.
• Care coordinators (providers who keep you up to date on your treatment plan and advocate on your behalf).

We explore all options when we plan your treatment for a myeloproliferative neoplasm. We want to offer you the best chance for a long, healthy life.

Treatment for myeloproliferative neoplasms focuses on relieving symptoms, slowing disease progression and reducing your risk for complications like acute myeloid leukemia.

For all types of myeloproliferative neoplasms, the only known cure is allogeneic stem cell transplantation. But not everyone can go through this process. There are other ways to manage these conditions if a stem cell transplant isn’t an option. We make sure you understand all treatment options for your type of MPN.

We can use different treatments to reduce the number of blood cells, provide symptom relief and avoid complications. Depending on the type of MPN, your treatment may include:

• Watchful waiting.
• Chemotherapy.
• Immunotherapy.
• Targeted therapy.
• Radiation therapy.
• Corticosteroids.
• Blood transfusions.
• Phlebotomy (therapeutic bleeding).
• Medications to avoid blood clots.

Living With Myeloproliferative Neoplasms

While some myeloproliferative neoplasms can be cured and go away, others may be chronic or come back after treatment (recur). You’ll have regular check-ups with your care team and frequent testing to keep an eye on your health, and to manage or prevent symptoms — and see if your MPN recurs. If it does, we can start treatment right away. 

Having blood cancer can be stressful. And we’re here to help you manage that stress. There are many ways to do that — personalized eating and exercise plans, support groups or psychotherapy, to name a few. You can get the care you need for the whole you when you need it.

Taking the Next Step

No one plans on hearing, "You have blood cancer." But when you do, you don’t have to go through this journey on your own. Cleveland Clinic’s team of dedicated rare blood cancer healthcare providers and other specialists are here to guide you through each step. They work together (and with you) to find the best treatments and compassionate support so you can thrive as you move forward.