Spleen Facts Every Myelofibrosis Patient Need to Know
The spleen is an organ located in your midsection underneath the ribs on the upper left side of the abdomen. In patients with myelofibrosis (MF), an enlarged spleen is the most common symptom, resulting in 90 percent of patients at the time of diagnosis.
If an enlarged spleen is suspected, doctors will feel the abdominal area and can confirm the diagnosis with an ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scan.
Spleen Filters Your Blood
The spleen’s job is to produce white blood cells to fight infection and disease-causing germs. Old and damaged blood cells are also removed while storing red blood cells and platelets to help with blood clotting.
The spleen acts as a security guard by only allowing blood cells that are healthy through. Doing so maintains blood circulation clean and functioning properly. Old and damaged red blood cells are broken down for the remaining useful components (iron).
Spleen Fights with Bacteria
The spleen can locate and remove bacteria from the bloodstream. Lymphocytes, which are white blood cells, collect bacteria surrounded with coating and destroy them. Bacteria can be transferred from person to person through saliva or mucus. A carrier may sneeze or cough on or near you, which rarely causes illness in healthy people. However, those with MF or other diseases impairing the spleen can become ill if the immune system is unable to deal with the bacteria.
Pneumococcus, meningococcus, and Haemophilus influenzae type B are the most common bacteria that cause infection in those without a functioning spleen. Those without a spleen, either from birth (asplenia) or a splenectomy, are also at an increased risk of bacterial infections for life.
Is it Possible to Live Without a Spleen?
It is possible for MF patients and those with other diseases affecting the spleen to live without a functioning spleen or a spleen at all. It is important to understand how MF will affect your life.
Other tissues including the lymph nodes and liver can help support the body after a splenectomy. This of course bears a lifetime risk of increased susceptibility to infection and generally patients are less active after the procedure.
If Your Spleen is Overworked, it Can Enlarge
Myelofibrosis patients have scarring of the bone marrow, where blood cell production occurs. Without enough blood cells being made, the spleen needs to help and becomes overworked. Then, the spleen grows larger and is referred to as splenomegaly.
An Enlarged Spleen Can Cause Noticeable Symptoms
As the spleen enlarges, pain and discomfort are common in the abdomen and beneath the ribs. An enlarged spleen can also cause a loss of appetite or feeling full after only eating small amounts. This leads to weight loss in some cases. Other symptoms of an enlarged spleen include low levels of red blood cells, frequent infections, and bleeding easily.
Several Diseases That Affect the Spleen
There are several diseases of the spleen that can develop from MF or develop into secondary MF including:
- Ruptured spleen: This can occur following an injury or direct impact and cause internal bleeding that can be life-threatening in some cases. The spleen may burst at the time of the injury or can sometimes burst days or even weeks later. Some diseases, such as malaria and infectious mononucleosis, are more likely to cause a ruptured spleen because they cause the spleen to swell and the protective capsule to become thinner.
- Sickle cell disease: This is an inherited form of anemia, which is characterized by a dysfunctional type of hemoglobin. In this form of anemia, abnormal crescent-shaped red blood cells block the flow of blood, causing damage to organs such as the spleen.
- Splenic infarction: If the blood supply in the spleen is reduced, it is called splenic infarction. This occurs if a blood clot or something else cuts off the blood supply through the splenic artery. This often causes pain, and treatment varies depending on the underlying cause.
- Thrombocytopenia: After the spleen becomes enlarged, it may store an excess number of platelets until there are not enough in the rest of the body’s circulatory system. The most common symptom is patients easily bleeding due to not enough platelets being available to help blood clot.
- Spleen cancer: This type of cancer is rare. If the cancer develops in the spleen it is known as primary spleen cancer. If the cancer develops somewhere else in the body, then spreads to the spleen, it is called secondary spleen cancer.
The Spleen Can Be Examined in Different Ways
The spleen can be examined in multiple ways to help understand the underlying cause of the enlarged spleen. Doctors will examine the spleen to confirm the diagnosis and monitor the function of the organ with tests such as:
- Blood tests, such as a complete blood count (CBC), check the number of blood cells (red blood cells, white blood cells and platelets) in your system and liver function.
- Ultrasound or CT scans determine the size of the spleen, and whether it’s crowding other organs.
- MRI to track the blood flow through the spleen.