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Advanced Care for Myeloproliferative Neoplasms

Myeloproliferative Neoplasm Treatment

Your dedicated partner for long-term blood cancer care.

Receiving a diagnosis for a rare type of cancer like myeloproliferative neoplasm can be overwhelming. Our dedicated hematologists and oncologists are blood cancer experts who are fully dedicated to helping you understand your condition and find the best treatment possible. You’ll be surrounded by an entire care team offering advanced medical treatments, emotional support and symptom management.

What are Myeloproliferative Neoplasms (MPNs)?

Myeloproliferative neoplasms (MPN) can occur when abnormal stem cells in your bone marrow cause your body to overproduce red blood cells, white blood cells and/or platelets. More than 250,000 people in the U.S. are living with myeloproliferative neoplasm, diagnosed as essential thrombocythemia (ET), myelofibrosis (MF), polycythemia vera (PV) or chronic myeloid leukemia (CML).

You are unique, which is why the hematology experts at Novant Health Cancer Institute will work closely with you to develop an individualized treatment plan. Because treatment options may change over time as your condition progresses, you’ll be encouraged to visit your care team regularly. Ongoing monitoring and follow-up are important so we can make sure your treatment is effective and we can identify and address any potential complications.

Types of Myeloproliferative Neoplasms

Essential Thrombocythemia (ET)

Essential Thrombocythemia is a rare blood disorder that occurs when abnormal stem cells in your bone marrow make too many platelets (the blood cells that control bleeding). Essential thrombocythemia increases the chance for excessive bleeding and blood clotting, which may block your blood flow. Clots can develop anywhere in the body, including the brain, hands and feet. Clotting puts you at an increased risk for heart attack or stroke. So, it’s important to develop a close relationship with your doctor who can help you manage your condition.

Essential Thrombocythemia symptoms

You may not have any symptoms, but could experience:

• Headache
• Dizziness
• Shortness of breath
• Burning in the palms of the hands or soles of the feet
• Redness in the palms of the hands and soles of the feet
• Bruising and bleeding.

Essential Thrombocythemia treatment

To diagnose your condition, you may undergo a complete blood count (CBC) to measure your blood cell levels, following a bone marrow aspiration and biopsy. Your personalized treatment plan will be based on your lab results, symptoms and age. Treatment may include medications to prevent blood clots and lower platelet levels. Our team will work closely with you to determine a treatment that provides the best results to meet your goals. Medications could include:

Aspirin to prevent blood clots
Hydroxyurea (Hydrea®), an oral chemotherapeutic drug that lowers platelet levels
Anagrelide (Agrylin®), which slows platelet production from the bone marrow and may be used for patients who are not benefiting from hydroxyurea
Interferon alfa (Multiferon®), used to stimulate the body’s immune system to fight the cancerous cells
Busulfan (Myleran®), an oral chemotherapeutic drug that lowers platelet levels and may be used for patients who are not benefiting from hydroxyurea
Systemic anti-coagulation, which may be used for patients who are at higher risk of blood clots and/or for those who have a personal history of blood clots
Ruxolitinib (Jakafi®), one of the first targeted therapies for this disease, may be used to treat patients who are experiencing frequent symptoms or who have an enlarged spleen

Myelofibrosis (MF)

Primary myelofibrosis is a rare form of bone marrow cancer that affects the stem cells responsible for producing healthy blood cells. The abnormal cells cause fibrous tissue to grow in your bone marrow.

Myelofibrosis symptoms

Typical myelofibrosis symptoms may include:

• Fatigue and weakness
• Anemia
• Easy bruising and bleeding
• Night sweats
• Weight loss
• Abdominal discomfort or a feeling of fullness from an enlarged spleen, which may increase your risk of infection

Myelofibrosis Treatment

To determine your diagnosis and develop an individualized care plan, you may undergo a combination of laboratory tests including blood tests, imaging tests such as MRI, and a bone marrow biopsy.

Your hematology care team will work with you to create a myelofibrosis treatment based on the severity of your condition and your individual needs and preferences. Myelofibrosis treatment options may change over time as your condition progresses and as new treatments become available. Your hematology care team will work closely with you to ensure you are receiving appropriate treatment as your condition changes over time. Common treatments for myelofibrosis include:

Blood Transfusions to replace the missing red blood cells and alleviate fatigue and weakness associated with anemia.
Platelet Transfusions to help prevent bleeding.
Iron Chelation Therapy, which removes excess iron from the body.
JAK Inhibitors, a new class of drugs developed specifically for myelofibrosis that block the signals that drive the abnormal growth of blood cells.
Stem Cell Transplant, for severe cases of myelofibrosis. It involves replacing the damaged hematopoietic stem cells in the bone marrow with healthy ones.
Supportive Care to help manage the symptoms of myelofibrosis may include pain management, treatment for infections, and measures to reduce the risk of bleeding.

Polycythemia Vera (PV)

Polycythemia vera (PV) blood disorder is the most common form of myeloproliferative neoplasms. It occurs when there are too many red blood cells made in the bone marrow. Many times, the change in your blood cells is discovered from routine blood tests requested by your primary care physician. Polycythemia vera is diagnosed from blood tests or by a bone marrow biopsy performed by your hematologist.

Polycythemia Vera symptoms

Polycythemia vera develops slowly and symptoms may not develop for years, but could include:

• Headache
• Dizziness
• Itching or pain of the skin
• Abdominal fullness
• Blood clots or bleeding

Polycythemia Vera treatment

Polycythemia vera treatment focuses on preventing complications, such as blood clots. We also focus on addressing your symptoms, such as itchy or painful skin, or abdominal discomfort from a large spleen. At Novant Health Cancer Institute, your hematologist will work closely with you to develop a personalized plan.

Aspirin to prevent blood clots and phlebotomy (a procedure to remove the right amount of blood to lower hemoglobin and hematocrit)
Hydroxyurea (Hydrea®), an oral chemotherapeutic drug that lowers platelet levels
Interferon alfa (Multiferon®), used to stimulate the body’s immune system to fight the cancerous cells
Busulfan (Myleran®), an oral chemotherapeutic drug that lowers platelet levels and may be used for patients who are not benefiting from hydroxyurea
Ruxolitinib (Jakafi®), one of the first targeted therapies for this disease, may be used to treat patients who are experiencing frequent symptoms or who have an enlarged spleen

Chronic Myeloid Leukemia (CML)

Chronic myeloid leukemia (CML) is a chronic bone marrow and blood cancer that can be managed with treatment. Once a life-threatening disease, the introduction of TKI therapy in 2001 has transformed chronic myeloid leukemia to a manageable chronic condition. People with chronic myeloid leukemia are living longer and experiencing fewer treatment side effects.

Chronic myeloid leukemia is diagnosed from a simple blood test. You may also undergo a bone marrow biopsy to help define the phase of your condition. This enables your care team to provide the best treatment plan for you.

Chronic myeloid leukemia treatment

Chronic myeloid leukemia is a chronic condition that typically can be successfully controlled for the duration of your natural life through oral medicines. The primary treatment for chronic myeloid leukemia is a daily oral drug therapy called tyrosine kinase inhibitor (TKI) therapy. TKI therapy offers a way to manage this chronic condition, even providing a cure for some people.

There are six different TKIs and the best treatment for you depends on your lab results and previous health conditions. Your care team will regularly check your blood work and adjust your medicine as needed.

Your Cancer Support Services

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The compassionate, personalized support you deserve.

Our certified nurse navigators are specially trained to guide you throughout your entire treatment journey. They'll help you understand your diagnosis, review your cancer treatment options with you, answer questions, help you schedule appointments to minimize clinic visits, and provide resources and encouragement every step of the way.

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Access emotional & spiritual resources.

Cancer impacts your whole family. Take advantage of Novant Health cancer resources like counseling, cancer support groups, educational programs, and referrals to financial resources. We help you and your loved ones manage your emotional and practical needs during cancer diagnosis and treatment.

There may be times during your diagnosis, treatment or recovery when you want deeper spiritual and emotional support. We offer multi-faith support and guidance to you and your family members. Let your physician or nurse know if you would like to speak with a chaplain.

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You deserve to thrive.

Fighting cancer can take a toll on your body. To help you get stronger and more comfortable, we offer a wide range of personalized services to help you manage your symptoms. These services can include nutrition counseling, exercise coaching, physical therapy, rehabilitation and lymphedema treatment. Many of our clinics also provide board-certified specialists in palliative care and pain management.

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Care for the whole you.

At Novant Health, we’re committed to care for all of you during your treatment. Integrative medicine is evidence-based treatment available in the Charlotte and Winston-Salem areas that, when combined with medical therapies, can enhance your overall healing and well-being through treatment and beyond. We’ll connect you with holistic care that may include services like pet therapy, massage, meditation and stress management, nutrition counseling, wellness programs, acupuncture and yoga.

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Early detection, better outcomes.

Most cases of cancer occur by chance. However, sometimes cancer can be hereditary, which means that it runs in the family. Genetic counseling and genetic testing can help determine if you or your family members are at an increased risk to develop certain types of cancer. Understanding your hereditary risks can help prevent cancer, detect it early, or impact treatment decisions for an existing cancer. Our genetic counselors can talk with you about your family history of cancer and genetic testing options.

Who treats myeloproliferative neoplasms?

Your team of specialists will use their years of experience along with the most advanced diagnostic and cancer-fighting tools available to deliver the quality care you deserve. This multidisciplinary team meets weekly to review your treatment options and progress, and typically includes members with expertise in:

Medical oncology
Radiation oncology
Pathology
Mental health
Nutrition
Symptom management
Cellular immunotherapy
Stem cell transplantation

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Another perspective on your case and options can give you some peace of mind. Reach out for a virtual session or in-person consultation.

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Together, we can beat cancer. Clinical research studies drive breakthroughs in the prevention, detection and treatment of many cancer conditions.

If eligible to join a clinical trial, you could access new cancer treatments before they’re available to the general public. Explore clinical trials and speak with your cancer team to see if any are right for you.

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Why Choose Novant Health?

Accredited by multiple national organizations, including the Commission on Cancer and the Quality Oncology Practice Initiative (QOPI®), your Novant Health physician is committed to providing excellence in cancer care. You can feel confident that you will be supported throughout your cancer journey by a specialized team of experts focused on your specific needs. We work in state-of-the-art cancer care centers that are among the best in the country.

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Your cancer journey is unique. That’s why our nationally recognized cancer teams work with you to develop a personalized care plan. At Novant Health, you’ll have access to the most current treatment options available only at leading cancer institutes. Your treatment may include clinical research trials or robotics, microsurgeries, new radiation technologies, or cellular and immune therapies. Together, we can treat your cancer, manage your symptoms, and provide you with support at all stages.

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You're not alone on your cancer journey. At Novant Health, rest assured you’ll have all the resources you need to tackle your life-changing diagnosis. Our multidisciplinary, collaborative approach brings together experts with knowledge from different specialties to support you every step of the way. In addition to oncologists, radiologists, and surgeons, your team may include nurse navigators, nutritionists, integrative medicine specialists, genetic counselors, social workers, symptom management and palliative care specialists, and more.

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