Myeloproliferative neoplasms

Myeloproliferative neoplasms overview

Fred Hutchinson Cancer Center is recognized as a Center of Excellence by the Myelodysplastic Syndromes Foundation for the diagnosis and treatment of myeloproliferative neoplasms (MPN), also called myeloproliferative disorders, and myelodysplastic syndrome, a group of chronic bone marrow diseases that affect blood-forming stem cells.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

What to expect

Everyone who comes to Fred Hutch with myeloproliferative neoplasm (MPN) has a personal team that includes a hematologist, social worker, physical therapist, nutritionist, and nurse case manager.

Having a serious illness can feel overwhelming. Your experienced, compassionate team is ready to help you adjust to what’s happening. You may want to read the section on patient support. You may want to join a support group, or talk to a social worker or chaplain.

If you have questions about your condition, your treatment, and your future, write them down and bring them with you when you see your doctor.

Ask someone you trust to go with you to doctors’ appointments and tests. This person can provide emotional support and help you by keeping track of questions you want to ask, taking notes, and doing research on your disease and treatment options.

Hematologist A physician who specializes in diseases of the blood and blood-forming tissues.
Before your visit

It’s important to be evaluated thoroughly soon after diagnosis (or even with a suspected diagnosis) of MPN to determine where you are in the spectrum of these diseases and devise an individualized long-range management plan. Our team provides state-of-the-art evaluation, including using new research tools to pinpoint your diagnosis if it is still in question.

Before your first visit, your team will have reviewed your pathology slides (tissue samples from any biopsies), if available, and any scans or tests you have already had. The team may also want to repeat one or more of the tests since these diseases are progressive and our recommendations can be most meaningful to you if they are based on the most up-to-date results.

If you do not live in or near Seattle, we may ask your referring doctor to arrange for additional tests or scans so that these results are available before your appointment at Fred Hutch. However, bone marrow tests are best done at our center. This allows us to base our recommendations on the most up-to-date information about your bone marrow. Also, our doctors and nurses do these tests almost daily and are truly experts.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets.
During your visit

During your first visit to Fred Hutch, you will meet with your doctor, a hematologist who specializes in caring for people with blood diseases. Together you will go over your medical history and your current problem. This will usually be followed by a physical exam. Then you will sit down for a conference with your doctor and other members of your health care team to discuss a treatment plan.

We will give you information about what medical science has to offer, and we will explain how the various options should be used in your particular situation.

This visit usually lasts one to two hours. You are encouraged to bring a list of questions with you, and we recommend that you bring a friend or family member with you to your appointment for emotional support and to help you keep track of the information your team will be giving you. 

Hematologist A physician who specializes in diseases of the blood and blood-forming tissues. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Where you will be seen

If you have been referred to Fred Hutch with a diagnosis (or suspected diagnosis) of MPN, you will most likely be seen at the medical oncology clinic on the fourth floor of the South Lake Union clinic. Our doctors also see patients on the sixth floor.

Follow-up

You may need to visit your doctor on a regular basis to check your health. During these visits your doctor will give you a physical exam and may give you tests to detect signs of disease. These may include blood tests, imaging procedures, and assessments of your bone marrow. Follow-up visits are also a good time to talk with your doctor about how to manage any side effects you may have from your treatment. Your doctor will explain how often you need to visit.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Sign In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. Some examples of signs are fever, swelling, skin rash, high blood pressure and high blood glucose.

Facts

MPN are a group of diseases that affect blood-cell formation. In all forms of MPN, a bone marrow problem leads to increased levels of blood cells circulating in the bloodstream.

Treatment

The doctors at Fred Hutch and UW Medicine, are world leaders in research to better understand and more effectively treat these diseases.

Fred Hutch offers a range of standard therapies for MPN such as medications to reduce high blood counts, supportive care to relieve symptoms, and chemotherapy to control abnormal blood cells. Some of our patients benefit from drugs like imatinib (Gleevec) and ruxolitinib (Jakafi), which inhibit abnormal proteins related to specific gene mutations that occur in some types of MPN. In addition, we offer treatments that are not yet commercially available but show promise in clinical studies.

We also offer bone marrow transplantation (also called stem cell transplantation or hematopoietic cell transplantation)—the only treatment option with the potential to cure MPN.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.

Providers

At Fred Hutch, you receive care from a team of providers with extensive experience in your disease. Your team includes physicians, a patient care coordinator, a registered nurse, an advanced practice provider and others, based on your needs. You also have access to experts like nutritionists, social workers, acupuncturists, psychiatrists and more who specialize in supporting people with cancer or blood disorders.

Clinical trials

Fred Hutch was formed, in part, to bring promising new treatments to patients faster. For myeloproliferative neoplasms (MPN) patients, this means more treatment options at Fred Hutch than you might find elsewhere, including the chance to participate in one of many ongoing clinical trials conducted at both Fred Hutch and UW Medicine.

Resources

There are many resources online for learning about your disease. We’ve compiled a list of trusted sources to help you get started. If you or your caregiver are seeking additional information or resources, our Patient and Family Resource Center is available to help connect you with what you need.

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