Even if it is not present at diagnosis, weight loss often becomes troublesome, particularly in the advanced stages of the disease. It usually appears to be out of proportion to the degree of anorexia. Edema of the lower extremities becomes more common with disease progression and may be produced by the enlarged spleen and liver with compression of the inferior vena cava. No form of therapy has as yet been shown to prolong survival or to have a consistent beneficial effect on the progression of myelofibrosis. Because many proposed treatments carry a significant risk of morbidity or even mortality, there must be a clear indication for the intervention.
Standard care is supportive and directed toward specific complications.
Because of variability in Androgens and Corticosteroids Androgens may be given to treat severe anemia, especially when the anemia results primarily from decreased red cell production . Some authors recommend aggressive treatment with chemotherapy early in the course of disease because AMM is a disorder of clonal stem cell proliferation. Because chemotherapy rarely induces a hematologic remission and has not yet been shown to alter the overall course of disease, most investigators have restricted its use to relief of symptoms. Cytoreductive therapy can often reduce the size of the liver and spleen and alleviate weight loss, fever and night sweats. It may also be useful in reducing leukocyte and Irradiation Several situations warrant use of radiation therapy.