MPN Symptoms: Why Does Bone Pain Occur?

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Bone pain can occur in patients living with myeloproliferative neoplasms (MPNs) and can interfere with quality of life. Why does bone pain arise in MPN patients? What treatment options are available? MPN expert. Dr. Abdulraheem Yacoub from the University of Kansas Medical Center, explains the root of the symptom and how to manage it. Watch now to gain a better understanding of the source of bone pain and available therapies to alleviate the symptom.

Produced in partnership with The University of Texas MD Anderson Cancer Center. We thank Incyte for their support.

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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.

Tom Campbell:

Hi I’m Tom Campbell. I have a question. We talked about sweating and fatigue and a few other symptoms. 

But one symptom that we hadn’t mentioned is the bone pain. I kept wondering about how does that manifest itself? Is it because we’re producing different amounts of red cells or white cells? Or is it more prevalent in different MPNs? I don’t know how it manifests itself.

Beth Kart Probert:           

And, Dr. Yacoub, would you mind taking that one?

Dr. Yacoub:         

So the bone pain is probably one of the more difficult symptoms to nail. And, again, there are multiple reasons why a normal person would have bone pain adding to it having a myeloproliferative neoplasm where your bone marrow, which is located in your bone, is it working extra hard making extra blood. So that’s one reason. And then, the scarring that could happen would pull internally, cause some negative pressure inside the bone, which can be painful.

Also, the micro clotting that could happen inside the bone, so, small, little clots inside the bone can kill small pieces of the bone. And that’s very painful. And then, all of the blood production has a by-product of a lot of cytokines and hormones that can cause bone pain. And in each individual, there might be more than one of those happening at the same time or completely different reasoning why the pain is happening. So there might be multiple answers to your question or to the reasons there is bone pain in patients with myeloproliferative neoplasms. And there might be a trial-and-error kind of process in how to deal with that.

So if you think it’s really the disease being so proliferative, then those cytoreduction drugs Dr. Verstovsek mentioned like hydroxyurea (Hydrea) or interferon can help tone down the blood production and the hormones.

 

JAK inhibitors can help block the cytokines. Blood thinners, if indicated or aspirin, would be the treatment for the clotting part. Or simple pain medicines can be enough sometimes. So it really is going to be a process of trial and error and try to find out which specific path is causing your specific pain after you’ve eliminated the rest and treating them one at a time or all at the same time to try to get to the right answer. But it’s one of the more refractory or difficult to eliminate problems.

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 February 13, 2018