Myelofibrosis is a form of blood cancer. It causes scar tissue to develop in the bone marrow. A type of chronic leukemia, myelofibrosis also leads to increased production of abnormal blood cells. Over time, these abnormal cells start replacing normal healthy cells, leading to various symptoms such as anemia, which causes weakness and fatigue. Although myelofibrosis is a rare blood cancer, its warning signs and symptoms are often similar to other chronic health conditions.

Warning signs of myelofibrosis
Myelofibrosis is known to progress slowly over several years. So, the symptoms do not become apparent in the early stages. In fact, nearly one-third of those who are diagnosed with myelofibrosis do not show the signs in the starting stage. Once the symptoms start to show up, they quickly become worse. So, a person usually experiences severe fatigue. Often, the spleen also becomes enlarged. Some of the common warning signs of myelofibrosis include the following-

• Fever
• Itching
• Pale skin
• Loss of appetite
• Night sweats
• Frequent infections
• Enlarged spleen or liver
• Bone or joint pain
• Pain or fullness below the ribs on the left side
• Unexplained blood clots
• Abnormal bleeding or bruising
• Enlarged veins in the stomach and esophagus, which may sometimes rupture and bleed
• Shortness of breath

If any of these symptoms last long, it is important to consult a healthcare provider to ensure timely diagnosis and treatment.

Diagnosis
An oncologist usually diagnoses myelofibrosis. They start by conducting a physical examination and asking about the patient’s health history. Then, they check for any symptoms that indicate anemia and an enlarged spleen. To determine if a person has myelofibrosis, the healthcare provider might recommend the following tests-

• Complete blood count test  – Also known as CBC, this examination is done to check the number of blood cells in one’s body. If there is a low number of red blood cells and high levels of white blood cells or platelets, it might be due to myelofibrosis.
• Peripheral blood smear – Also known as PBS, this test shows whether the blood cells have any unusual shape, size, or features. It also checks whether there are many immature blood cells, which might be a sign of myelofibrosis.
• Blood chemistry tests  – These tests monitor the levels of multiple substances released by the organs into the bloodstream. For instance, high levels of bilirubin, uric acid, and lactic dehydrogenase might indicate myelofibrosis.
• Bone marrow biopsy  – In this procedure, the health expert extracts a bone marrow sample. They then examine it under a microscope to analyze the cells and confirm whether a person has myelofibrosis.
• Bone marrow aspiration  – This test involves removing a small amount of fluid from the bone marrow and examining it under a microscope for signs of myelofibrosis.
• Imaging procedures  – Sometimes, doctors may perform an ultrasound to check whether the spleen is enlarged. An MRI may also be performed to look for scar tissue in the bone marrow.