Myeloproliferative neoplasms (MPN) are a group of blood cancers that affect the production and function of blood cells. Women with MPN may face some specific challenges and issues, such as the impact of MPN on their quality of life, productivity, and reproductive health; the effect of gender on the presentation and prognosis of MPN; and the management of MPN during pregnancy and menopause. Women with MPN should consult with their hematologist and other specialists to address these issues and receive individualized care.
Content guide
Women with MPN: Challenges and Solutions
Myeloproliferative neoplasms (MPN) are a group of blood cancers that affect the production and function of blood cells. MPN can cause various symptoms and complications, such as anemia, bleeding, infections, blood clots and bone marrow fibrosis. MPN can affect anyone, but women with MPN may face some specific challenges and issues, such as:
The impact of MPN on their quality of life, productivity, and reproductive health.
Women with MPN may experience more fatigue, depression, anxiety, and sexual dysfunction than men with MPN¹. These symptoms can affect their daily activities, work performance and relationships. Women with MPN may also have concerns about their fertility and family planning options, as MPN can affect their menstrual cycles, ovulation, and hormonal levels.
The effect of gender on the presentation and prognosis of MPN.
Some studies have suggested that women may be more likely to develop ET and PV than men, and that they may have a lower risk of thrombosis and progression to MF. However, other studies have found no significant gender differences in MPN outcomes². More research is needed to understand how gender influences the biology and behavior of MPN cells, and how it affects the response to treatment and survival of patients.
The management of MPN during pregnancy and menopause.
Women with MPN may have an increased risk of pregnancy complications, such as miscarriage, preeclampsia and fetal growth restriction³. They may also need to adjust their treatment during pregnancy and breastfeeding, as some MPN drugs may be harmful to the fetus or infant. Menopause may also affect the symptoms and treatment of MPN, as hormonal changes may influence blood counts, thrombosis risk and bone health.
Women with MPN should consult with their hematologist and other specialists to address these issues and receive individualized care. They should also seek support from patient advocacy groups, such as Global MPN Scientific Foundation, that provide information and resources for women with MPN. By learning more about their condition and sharing their experiences with others, women with MPN can empower themselves to cope better with the challenges they face.
References:
1. Geyer HL et al. The impact of sex on symptom burden among patients with myeloproliferative neoplasms: an analysis by the REVEAL study. Blood Adv 2019; 3: 3278-3286.
2. Tefferi A et al. Gender effect in primary myelofibrosis: a single center study of 1,262 patients. Leukemia 2014; 28: 2417-2419.
3. Palandri F et al. Pregnancy outcome in patients with essential thrombocythemia exposed to anagrelide during pregnancy: a systematic review. Haematologica 2019; 104: e478-e481.
Best treatment options for women with MPN
If you are a woman with a myeloproliferative neoplasm (MPN), you may wonder what the best treatment options for you are. MPNs are a group of blood disorders that cause the bone marrow to produce too many red blood cells, white blood cells or platelets. They can cause symptoms such as fatigue, itching, headaches, night sweats, weight loss and enlarged spleen. They can also increase the risk of blood clots, bleeding, and leukemia.
The best treatment options for women with MPN depend on several factors, such as:
The type and subtype of MPN they have (e.g., polycythemia vera (PV), essential thrombocythemia (ET), myelofibrosis (MF), etc.)
The risk level of their disease (e.g., low, intermediate, or high) based on their age, blood counts, symptoms and genetic mutations
The goals of their treatment (e.g., to reduce symptoms, prevent complications, slow disease progression, or improve survival)
Their personal preferences and values (e.g., their willingness to accept side effects, their quality of life and their reproductive plans)
Some of the common treatment options for women with MPN are:
Phlebotomy: a procedure that removes excess blood from the body to reduce the risk of blood clots and lower the blood volume and pressure. It is mainly used for PV.
Medications: drugs that can lower the number of blood cells, reduce inflammation, target specific genetic mutations, or stimulate the immune system. They include hydroxyurea, ruxolitinib, interferon-alpha, anagrelide and aspirin.
Stem cell transplant: a procedure that replaces the abnormal bone marrow cells with healthy ones from a donor. It is the only potentially curative option for MPN, but it is also very risky and only suitable for a small number of patients with high-risk MF.
Women with MPN should discuss their treatment options with their hematologist and other specialists to find the best option for their individual situation. They should also be aware of the possible effects of treatment on their fertility, pregnancy and menopause and seek appropriate advice and support.
This blog post is intended to provide general information about MPN and its treatment options for women. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult your doctor or other qualified health care provider before starting any new treatment or with any questions you may have regarding your medical condition.
References:
1. Treatment for Myeloproliferative Neoplasms (MPN) | Memorial Sloan .... https://www.mskcc.org/cancer-care/types/leukemias/treatment/treatment-myeloproliferative-neoplasms Con acceso 20/4/2023.
2. Myeloproliferative Neoplasms (MPN) - Leukaemia Foundation. https://www.leukaemia.org.au/wp-content/uploads/2021/11/Myeloproliferative-Neoplasms-MPN_A-guide-for-people-with-MPN.pdf Con acceso 20/4/2023.
3. 6 Myeloproliferative Neoplasm Treatment Options - MD Anderson Cancer Center. https://www.mdanderson.org/cancer-types/myeloproliferative-neoplasm/myeloproliferative-neoplasm-treatment.html Con acceso 20/4/2023.