understanding myelofibrosis
“mf is a cancer where scar tissue forms in the bone marrow,” says dr. brian leber, a clinical hematologist involved with the juravinski cancer centre and professor emeritus at mcmaster university. “because of the scarring, the rest of the bone marrow doesn’t function as well.”
depending on the stage of cancer at diagnosis, patients can present with low red blood cell counts, and either higher or lower-than-normal numbers of platelets and white blood cells.
“the bone marrow is where blood cells are most commonly made, but blood cell production can also take place in the liver and especially the spleen,” continues dr. leber. “when the bone marrow gets damaged, the spleen essentially takes over its function and becomes enlarged.”
other key signs and symptoms of mf include fatigue, easy bruising or bleeding, feeling full quickly, night sweats and anemia.
dr. leber also notes that while a normal red blood cell lives for three to four months, with an enlarged spleen, that time can dwindle to just one month due to the spleen’s role in red blood cell clearance. “the function of the spleen also contributes to the anemia,” he says.
mf affects more than blood counts and spleen size — it also drives systemic inflammation. “people can have widespread, systemic side effects,” says dr. leber. “some patients have the same degree of inflammation as somebody with severe untreated rheumatoid arthritis. there can be unintentional weight loss, bone pain and loss of appetite.”
mf is quite rare, making diagnosis challenging. while there’s no national mf registry, data suggests that the number of patients with mf in canada might be around 2,000, according to dr. leber.
living with myelofibrosis
for james, navigating life with mf has meant making adjustments. being a partner in his firm, he has no plans to quit working. “i’ll never retire,” he says. days at the office look a little different now, however.