What are the main treatment options for myelofibrosis?
For asymptomatic patients, no treatment is necessary.The profound anemia that develops in this disease usually requires red blood cell transfusion. Red blood cell survival is markedly decreased in some patients; this can sometimes be treated with glucocorticoids. Disease-associated anemia may occasionally respond to erythropoietin, hydroxyurea, cladribine, thalidomide, or interferon.Hydroxyurea is useful in patients with this disease but may have a potential leukemogenic effect (initiation or pregression of leukemic disease). In patients with thrombocytosis and abnormal enlargement of the liver after surgical removal of the spleen, cladribine has shown responses as an alternative to hydroxyurea. The use of interferon alfa can result in hematologic responses, including reduction in spleen size in 30% to 50% of patients, though many patients do not tolerate this medication. Favorable responses to thalidomide have been reported in about 20% to 60% of patients.
For asymptomatic patients, no treatment is necessary. The profound anemia that develops in this disease usually requires red blood cell transfusion. Red blood cell survival is markedly decreased in some patients; this can sometimes be treated with glucocorticoids. Disease-associated anemia may occasionally respond to erythropoietin, hydroxyurea, cladribine, thalidomide, or interferon. Hydroxyurea is useful in patients with this disease but may have a potential leukemogenic effect (initiation or pregression of leukemic disease). In patients with thrombocytosis and abnormal enlargement of the liver after surgical removal of the spleen, cladribine has shown responses as an alternative to hydroxyurea. The use of interferon alfa can result in hematologic responses, including reduction in spleen size in 30% to 50% of patients, though many patients do not tolerate this medication. Favorable responses to thalidomide have been reported in about 20% to 60% of patients. Another approach involves
