Myelofibrosis (MF) is an uncommon type of blood cancer that causes scarring in the bone marrow. It is a form of chronic leukemia and also a myeloproliferative disorder, which is a condition that results in too many abnormal cells in the bone marrow. Myelofibrosis can be of two types: primary, when it occurs on its own, and secondary, when it develops because of other blood disorders, such as primary thrombocytosis or polycythemia vera.

Treatment options
The treatment of myelofibrosis largely focuses on symptom management to ensure the least amount of pain and discomfort. Treatment also depends largely on the type of cancer one has and the symptoms one is experiencing.

Low-risk myelofibrosis treatment
When there are no symptoms present in the initial stages of the disease, doctors may not prescribe any treatment. Instead, they will focus on regular health checkups to closely monitor symptom changes and disease progression.

Intermediate- to high-risk myelofibrosis treatment
As the condition progresses, one may experience symptoms such as anemia, an enlarged spleen, and weakness. To manage these, doctors may recommend and prescribe certain treatment options.

1. Blood transfusions
This option can benefit those with severe anemia. Blood transfusion helps raise healthy red blood cell count and reduce anemia symptoms like fatigue or weakness.

2. Androgen therapy
For some people, taking a version of the male hormone androgen can help promote healthy red cell production, slowing down the spread of cancer and reducing symptoms of anemia.

3. Targeted therapy
For adults with myelofibrosis, doctors may prescribe targeted therapy like Jakafi (ruxolitinib) to work on specific abnormalities in the cells. This can help reduce enlarged spleen symptoms by reducing overactive JAK (protein Janus kinases) signaling and controlling blood cell production.

4. Chemotherapy
In some cases, doctors may recommend chemotherapy to reduce the size of the enlarged spleen and manage other symptoms like pain and inflammation.

5. Splenectomy
If the spleen becomes big enough to cause chronic pain and other health complications and does not respond to any other treatments, it may need to be removed surgically. This is called a splenectomy. Common risks of undergoing this treatment include frequent infections, excessive bleeding, and the formation of blood clots.

6. Radiation therapy
In certain severe cases of myelofibrosis, a splenectomy may not be possible. Here, doctors may recommend radiation therapy using high-powered beams like X-rays and protons to kill cancer cells and reduce the size of the spleen.

7. Bone marrow transplant
A stem cell or bone marrow transplant can help replace the scarred bone marrow with healthy cells. This procedure, called the allogeneic stem cell transplant, requires a compatible donor. Although this high-risk treatment has the potential to manage myelofibrosis to a great extent, not everyone can undergo it. The suitability of this option for those affected is determined by their age and existing health issues.

8. Palliative care
Some people with myelofibrosis may need special medical attention that focuses on relieving pain and improving their quality of life. This can be done via palliative care, which is often recommended in conjunction with other therapies like targeted treatment methods, radiation, or chemotherapy.