People who have myelofibrosis sometimes have an enlarged spleen. Your spleen can be surgically removed if it's very large and causes a very low platelet count, severe anemia or portal hypertension.
Your doctor carefully weighs the benefits versus the risks of a splenectomy before deciding whether to remove your spleen. You'll need to be evaluated before undergoing surgery and monitored after surgery for an increased risk of bleeding complications, including blood clot formation leading to a stroke or pulmonary embolism; infection; liver enlargement; and an increase in platelet count.