Myeloproliferative Neoplasms: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Myeloproliferative Neoplasms?
A hematologist, a doctor who treats blood diseases, usually cares for myeloproliferative neoplasms. An oncologist, a doctor who treats cancer, may also help. It is important to know the exact type in order to plan treatment. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are myeloproliferative neoplasms?
Myeloproliferative neoplasms are diseases in which the bone marrow makes too many red blood cells, white blood cells, or platelets. Normally, the bone marrow makes blood stem cells, which are immature cells that become mature blood cells over time.
The neoplasms usually get worse slowly as the number of extra blood cells increases. Types include:
- Polycythemia vera, in which too many red blood cells are made.
- Essential thrombocythemia, in which too many platelets are made.
- Primary myelofibrosis, in which abnormal blood cells and fibers build up in the bone marrow.
These diseases sometimes become acute leukemia. In this cancer, too many abnormal white blood cells are made.
Symptoms
Polycythemia vera often does not cause early symptoms. Symptoms may appear as the number of blood cells increases. Check with your doctor if you have:
- A feeling of pressure or fullness below the ribs on the left side.
- Double vision, or dark or blind spots that come and go.
- Itching all over the body, especially after being in warm or hot water.
Essential thrombocythemia can cause burning or tingling in the hands or feet, redness and warmth of the hands or feet, and vision or hearing problems.
Primary myelofibrosis can cause pain or a feeling of fullness below the ribs on the left side. It can also cause anemia, bone pain, tiredness, shortness of breath, and easy bruising or bleeding. Fever, drenching night sweats and weight loss can also occur.
Causes and who gets it
Researchers think polycythemia vera starts with changes in the DNA of a stem cell in the bone marrow.
Polycythemia vera is a rare disorder that occurs more often in men than in women. The JAK2 V617F gene change linked to it is not an inherited disorder.
Extra blood cells can make clots form in blood vessels. This can raise the risk of stroke or heart attack. The risk is higher in people older than 65 or with a history of blood clots.
How doctors diagnose it
Doctors use tests that examine the blood and bone marrow. A complete blood count counts the red blood cells, white blood cells and platelets.
A bone marrow biopsy removes bone marrow, blood and a bit of bone with a hollow needle.
Genetic testing checks a blood or bone marrow sample for changes in the JAK2, MPL or CALR genes. A JAK2 change is often found in polycythemia vera, essential thrombocythemia and primary myelofibrosis.
Treatment
Watchful waiting means closely checking your condition without treatment until symptoms appear or change.
For polycythemia vera, treatment aims to reduce the number of extra blood cells. Phlebotomy removes blood from a vein to take out extra red blood cells. Treatment may also include the chemotherapy medicine hydroxyurea, with or without phlebotomy.
If chemotherapy does not work, a targeted therapy called ruxolitinib may be used. Low-dose aspirin may also be used to reduce the risk of blood clots. Aspirin increases the risk of stomach bleeding.
For essential thrombocythemia, people younger than 60 with no symptoms and an acceptable platelet count usually have watchful waiting.
For primary myelofibrosis, people without symptoms usually have watchful waiting. Anemia is usually treated with red blood cell transfusions. Other options include ruxolitinib, a stem cell or bone marrow transplant, and surgery to remove the spleen. Follow your doctor's instructions about all of your medicines, including aspirin.
When to see a doctor
Other conditions may cause the same symptoms. Check with your doctor if you have symptoms like those above. Some of these diseases may be found during a routine blood test.
Polycythemia vera raises the risk of deep vein thrombosis. This is a blood clot in the deep veins of the arms or legs. If it travels to the lungs, it can cause a life-threatening clot called a pulmonary embolism.
Call 911 or go to the emergency room if you have chest pain, severe trouble breathing, fainting or sudden confusion. Also go if you have sudden weakness, a sudden change in vision, trouble speaking, or bleeding that will not stop.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms, order basic blood tests and refer you to a blood specialist.
Common questions
Can myeloproliferative neoplasms turn into leukemia?
Yes, sometimes. These diseases sometimes become acute leukemia.
Do myeloproliferative neoplasms cause symptoms early?
Often they do not. Polycythemia vera often does not cause early signs or symptoms. The same is true for essential thrombocythemia.
How are myeloproliferative neoplasms treated?
Treatment depends on the type. Options include watchful waiting, phlebotomy, medicines and sometimes a stem cell transplant.
Sources
- NCI - Myeloproliferative Neoplasms Treatment (PDQ) Patient Version
- MedlinePlus - Polycythemia Vera
- MedlinePlus Genetics - Polycythemia Vera
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
