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Disease Complications

As myelofibrosis (MF) progresses, complications may arise:

  • Bleeding. As MF progresses, the number of platelets may drop below normal levels. Insufficient platelets can lead to bleeding more easily than usual. Patients need to discuss bleeding concerns with their doctors when planning to have surgery or other medical procedures.
  • Abdominal and Back Pain. An enlarged spleen can cause pain when it pushes up against other organs.
  • Portal Hypertension. Normally, blood flow from the spleen enters the liver through a large blood vessel called the portal vein. When the spleen is enlarged, increased blood flow through the portal vein can lead to high blood pressure in the vein. This can force excess blood into smaller veins in the stomach and esophagus, potentially causing the veins to rupture and bleed. Portal hypertension may also be caused by a blood clot that develops in the portal vein, which may obstruct the blood flow through it.
  • Extramedullary Hematopoiesis. When the bone marrow is no longer able to make sufficient blood cells, other organs in the body such as the spleen may begin to produce blood cells. This often causes the spleen to become enlarged. Extramedullary hematopoiesis may also lead to the creation of clumps or tumors of developing blood cells in other areas of the body, which may cause bleeding in the gastrointestinal (GI) system, coughing or spitting up blood, compression of the spinal cord, or seizures. 
  • Bone and Joint Pain. Myelofibrosis can cause hardening of the bone marrow and inflammation of the connective tissue that surrounds the bones, resulting in severe bone and joint pain and tenderness.
  • Gout. MF increases the body’s production of uric acid. When uric acid builds up, it forms crystals in the joints causing sharp pain, swollen joints and inflammation.
  • Acute Myeloid Leukemia (AML). In about 10 to 20 percent of patients with myelofibrosis, MF will transform to AML, a type of blood and bone marrow cancer that progresses rapidly.


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