Primary Myelofibrosis

Primary myelofibrosis (PMF), also known as chronic idiopathic myelofibrosis, is a clonal hematopoietic stem cell disorder characterized by panmyelosis with morphologically normal cells across all lineages, bone marrow fibrosis, splenomegaly, and extramedullary hematopoiesis in various organs.

TCM Pattern Identification and Medication Reference

| Common Symptoms

Clinical description:

Fatigue and lack of energy, epigastric and abdominal fullness, a mass beneath the ribs that is soft rather than firm and fixed in place or painful, a dark-red tongue or purplish spots along the tongue edges, white coating, and a wiry, tight, or choppy pulse.

In plain language:

  • Low energy; you may tire easily and feel too listless to get things done.
  • A feeling of fullness or discomfort in the upper and lower abdomen, often with a sense of pressure or blockage.
  • Lumps may be felt beneath the ribs. They may feel somewhat soft rather than hard, remain in one place, or be painful.
  • The tongue may appear dark red, or purplish spots may be visible along its edges.
  • The tongue coating is white.
  • The pulse may feel taut like a string or rough and uneven.

| Treatment Approach

Clinical description:

Soothe the liver, resolve blood stasis, regulate qi, and reduce accumulations.

In plain language:

  • May help soothe liver qi and resolve stagnation, easing fullness in the chest and sides, fixed stabbing pain, or menstrual irregularities.
  • May help regulate qi and reduce accumulations, easing abdominal fullness, dull pain around a mass, or poor appetite.

| Related Products

The products listed below are for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

| Common Symptoms

Clinical description:

Fatigue and lack of energy, palpitations and shortness of breath, dizziness, a firm mass, fixed pain, a pale or dark tongue, and a wiry, fine, deep, or thready pulse.

In plain language:

  • Low energy and easy fatigue.
  • Palpitations and a feeling of shortness of breath.
  • Dizziness or lightheadedness.
  • The mass feels firm to the touch.
  • The pain stays in one place rather than moving around.
  • The tongue appears pale or dark.
  • The pulse feels wiry and fine, or deep and fine.

| Treatment Approach

Clinical description:

Tonify qi and nourish blood; invigorate blood and resolve blood stasis.

In plain language:

  • May help replenish qi and blood, easing fatigue, shortness of breath, pale complexion, dizziness, or palpitations.
  • May help promote blood flow and resolve blood stasis, easing purplish spots, pain, or menstrual irregularities.

| Related Products

The products listed below are for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

| Common Symptoms

Clinical description:

Fatigue and lack of energy, epigastric and abdominal fullness, reduced appetite and loose stools, soreness and weakness in the lower back and knees, a mass that gradually enlarges and is hard and fixed, a pale-dark tongue, white coating, and a deep, fine pulse.

In plain language:

  • Low energy and easy fatigue.
  • A feeling of fullness or discomfort in the upper and lower abdomen.
  • Poor appetite and eating less than usual.
  • Loose stools.
  • Soreness and weakness in the lower back and knees.
  • The mass gradually gets larger.
  • It feels hard and does not move.
  • The tongue appears pale and somewhat dark.
  • The tongue coating is white.
  • The pulse feels deep and fine.

| Treatment Approach

Clinical description:

Warm and tonify the spleen and kidneys; replenish essence and nourish blood.

In plain language:

  • May help warm and support yang in the spleen and kidneys and nourish the body’s vital qi, easing sensitivity to cold, cold limbs, poor appetite, soreness and weakness in the lower back and knees, or low energy.
  • May help replenish essence and blood, easing dizziness, tinnitus, pale complexion, palpitations, or fatigue.

| Related Products

The products listed below are for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

You Gui Wan
Ren Shen Yang Rong Wan

| Common Symptoms

Clinical description:

Low-grade fever and night sweats, weight loss and fatigue, a sensation of heat in the palms, soles, and chest, soreness and weakness in the lower back and knees, a very large, hard, fixed mass, a small, thin tongue that is pale and dark, a white coating or little coating, and a weak, fine pulse.

In plain language:

  • A slight fever, with sweating during sleep at night.
  • Noticeable weight loss and easy fatigue or weakness.
  • The palms, soles, and chest often feel hot.
  • Soreness and weakness in the lower back and knees.
  • The mass below the chest is very large.
  • It feels very hard and does not move when pressed.
  • The tongue is small and thin, and appears pale and somewhat dark.
  • The tongue coating is white or sparse.
  • The pulse feels fine and weak.

| Treatment Approach

Clinical description:

Nourish the liver and kidneys; tonify qi and promote blood production.

In plain language:

  • May help nourish the liver and kidneys, easing dizziness, tinnitus, soreness and weakness in the lower back and knees, or low energy.
  • May help replenish vital qi and support blood production, easing pale complexion, fatigue, shortness of breath, dizziness, or palpitations.

| Related Products

The products listed below are for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Zuo Gui Wan
Xue Fu Zhu Yu Tang

References

  1. Zhang Zhinan, Hao Yushu, Zhao Yongqiang, et al. Hematology [M]. 2nd ed. Beijing: People’s Medical Publishing House, 2011: 933-947.
  2. James C，Ugo V，Le Couedic JP，et al. A unique clonal JAK2 mutation leading to constitutive signaling causes polycythemia vera[J]. Nature，2005，434：1144-1148.
  3. Tefferi A，Thiele J，Orazi A，et al. Proposals and rationale for revision of the World Health Orgnization diagnostic criteria for polycythemia vera, essential thrombocythemia, and primary myelofibrosis: recommendations from an ad hoc international expert panel[J]. Blood，2007，110：1092-1097.
  4. Jabbour E，Kantarjian H，Cortes J，et al. PEGIFN-alpha-2b therapy in BCR-ABL-negative myeloproliferative disorders: final result of a phase 2 study[J]. Cancer，2007，110：2012-2018.
  5. Vannucchi AM，Antonioli E，Guglielmelli P，et al. Clinical Correlates of JAK2V617F presence or allele burden in myeloproliferative neoplasms: a critical reappraisal[J]. Leukemia，2008：1299-1307.
  6. Tefferi A，Barosi G，Mesa RA，et al. International Working Group (IWG) consensus criteria for treatment response in myelofibrosis with myeloid metaplasia, for the IWG for Myelofibrosis Research and Treatment (IWG-MRT)[J]. Blood，2006，108：1497-1503.
  7. Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: Clinical Medication Guide, Chinese Patent Medicines Volume [M]. Beijing: China Medical Science Press, 2011.