What signs of progression should I watch for

Signs of Progression to Watch For in Myelofibrosis

Based on NCCN Guidelines for Myeloproliferative Neoplasms, here are the key warning signs you should monitor and report to your oncologist:

Blood Count Changes

• Worsening anemia — increased fatigue, shortness of breath, dizziness
• Severe thrombocytopenia — new or increased bleeding/bruising
• Leukocytosis — very high white blood cell counts (can indicate blast phase)

Spleen-Related Symptoms

• Rapid spleen enlargement — increased abdominal fullness or pain on left side
• Early satiety — feeling full quickly when eating (from enlarged spleen pressing on stomach)

Constitutional Symptoms (Worsening)

• Uncontrolled night sweats — drenching sweats despite treatment
• Unexplained fever — persistent low-grade or high fever
• Significant weight loss — unintentional loss over weeks/months

Blast Transformation (Most Serious)

• Rapid increase in immature blood cells (blasts) — detected on blood tests
• Acute leukemia-like symptoms — severe fatigue, infections, bleeding
• This represents progression to acute myeloid leukemia (AML)

Treatment-Related Changes

• Loss of response to JAK inhibitors — symptoms returning despite medication
• Intolerance to current therapy — severe side effects requiring dose reduction

---

Report any of these to your oncologist promptly. Regular blood work (typically every 3-6 months) will catch many changes before you notice symptoms.

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.