[ Inglese] What Causes an Enlarged Spleen in Patients with MPNs?

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A common symptom of myeloproliferative neoplasm (MPNs) is an enlarged spleen.  So what causes an enlarged spleen in patients who have myelofibrosis, polycythemia vera or essential thrombocythemia?  As part of our “Ask the Expert” series, Dr. Ross Levine from Memorial Sloan Kettering Cancer Center explains what is happening inside the bone marrow and why this causes the spleen to become enlarged.

Sponsored by The Patient Empowerment Network which received an educational grant from Incyte Corporation. 

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Dr. Levine:

So what causes an enlarged spleen for patients who have myelofibrosis, polycythemia vera and essential thrombocytosis?  What we know is that the bone marrow, which is normally where blood cells reside, becomes full of scar tissue, no different than if you had a scar after an injury if you were playing a sport or something else. And the challenge is then where do the cells go.

And it turns out that the other place that the blood cells can go and reside and do their job is the spleen. And so the cells appear to exit the bone marrow and go to the spleen. And the problem is they then grow and like the spleen so much that they overgrow, and they actually make too many cells and they cause big spleens that cause symptoms.  Whereas, in normal patients who don't have scarring in their bone marrow, the cells never leave the bone marrow and don't go to the spleen.

So we really believe that it's a movement of cells from the bone marrow to the spleen.  And again, drugs like JAK inhibitors and other therapies appear to reverse that effect, and you get this reduction in the size of the spleen and a reduction in the normal—a reduction in the number of blood-forming cells in the spleen and hopefully over the long term a reduction in the scarring in the bone marrow.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on October 21, 2014