Myeloproliferative neoplasms (MPN) 

What are MPN?

Myeloproliferative neoplasms (MPN) are disorders that affect how the body produces red blood cells, white blood cells, and platelets.

Every day, our bodies create billions of blood cells - red blood cells (RBCs) to carry oxygen round the body, white blood cells (WBCs) to fight infections, and platelets to make the blood clot when we cut ourselves. These blood cells are produced from stem cells inside the bone marrow which grow and mature into blood cells. Usually the stem cells mature into blood cells in a very tightly-regulated way, under the control of a number of chemicals (hormones) in the blood stream. This ensures that we have just the right number of RBCs, WBCs and platelets.

Sometimes the stem cells develop an abnormality, often called a mutation, which means they produce too many (or sometimes too few) blood cells. When this happens, a blood disorder known as a myeloproliferative neoplasm (MPN) can result.

The four commonest MPN subtypes are:

  • essential thrombocythaemia (too many platelets);
  • polycythaemia vera (too many RBCs);
  • chronic myeloid leukaemia (too many neutrophils, which are a type of WBC);
  • myelofibrosis (replacement of the stem cells in the bone marrow by scar and fibrous tissue causing too few blood cells and often an enlarged spleen).

However, there are a number of rarer MPN such as systemic mastocytosis and hypereosinophilic syndrome. Sometimes people can have an MPN which has overlapping features such as both high platelets and high RBCs. It should also be noted that people can have high blood counts which are not caused by an MPN – for instance our platelet counts often go up as a natural response to an infection and return to normal afterwards.

  • Is MPN cancer?

    MPN are classed by the World Health Organization (WHO) as blood cancers because the bone marrow is producing blood cells in an uncontrolled way. However, patients with MPN often feel very well and in the majority of cases can live normal, or near-normal lives, with relatively gentle treatment. In fact essential thrombocythaemia and polycythaemia vera are regarded by some specialists as pre-cancerous conditions, rather than actual cancers, because patients with these conditions very rarely develop any cancer-type problems. The most significant problem associated with these two conditions is an increased risk of blood clots.

  • What causes MPN?

    In most cases, MPN are caused by the development of mutations in the genes of our stem cells, but we don’t yet really understand why some people develop these mutations and others don’t. These mutations are not usually inherited in the same way as, for instance, the mutations which cause haemophilia, so MPN do not normally run in families.

  • Treating MPN

    Treatment for MPN varies according to the exact subtype and other factors that are specific to an individual patient’s case. For example, people with chronic myeloid leukaemia usually take imatinib (or a similar drug), whilst people with essential thrombocythaemia and polycythaemia vera often take an aspirin, to reduce the risk of blood clots, and may also need to take other drugs to slow down their blood cell production.

    If you have an MPN, you will need to be assessed by a specialist consultant who has expertise in these conditions. They will then discuss with you what treatment options are recommended for you. If appropriate, we will also discuss relevant clinical trials with you, which may be evaluating new therapies or investigating the causes of MPN.

    MPN are relatively rare conditions and at UCLH we therefore have dedicated medical and nursing teams who specialise in looking after patients with these disorders. We have access to a wide range of specialist tests and therapies.

    We have one team who specialise in chronic myeloid leukaemia, and another team who specialise in the other MPN.

 Consultants

Dr Jonathan Lambert, Consultant Haemato-oncologist

Dr Jonathan Lambert

Dr Jonathan Lambert is a consultant haemato-oncologist at UCLH. He specialises in treating Myeloproliferative  neoplasms and  lymphoma.He is the clinical haematology undergraduate teaching programme at UCLH and lists his research interests as myeloproliferative neoplasms and lymphoma (particular interest in functional imaging in lymphoma).

“The most rewarding part of my work at UCLH is being  part of a dynamic, modern team with expertise in looking after people with even the most complex haematological cancers, and being able to provide cutting-edge anti-cancer therapies to patients who can benefit from them. I also greatly enjoy teaching students and other doctors”

Full consultant profile

Dr Mallika Sekhar, Consultant Haematologist

Dr Mallika Sekhar

Dr Mallika Sekhar is a consultant haematologist and honorary senior lecturer at UCL specialising in myeloproliferative diseases across UCLH and Royal Free hospitals with a special interest in patients with vascular thrombosis and myeloproliferative diseases. Her other specialist areas include acute leukaemia and transfusion medicine. She has been involved in writing guidelines on MPD for BCSH.

Full consultant profile

 Clinical Nurse Specialists (CNS)

Syeda Ahmed, Clinical Nurse Specialist for Myeloproliferative Neoplasms (MPN)

Syeda is a clinical nurse specialist in MPN. She has experience in haematology in both inpatients and outpatients as a ward nurse and ward manager. She joined the clinical nurse specialists in 2014 at the Royal Free Hospital to work with MPN patients. Syeda’s experience within haematology includes symptom management, chemotherapy, bone marrow transplant and acutely unwell patients.

Syeda has undertaken further studies and holds a BSc in haemato-oncology from Kings College London.

“The most rewarding part of my job is making a difference to the patients and their family’s lives by supporting them through their diagnosis and beyond.”

Flora Dangwa, Leukaemia Clinical Nurse Specialist

Flora is a clinical nurse specialist working with patients diagnosed with acute leukaemia and related myelodysplastic syndromes. She has experience working in haematology as a clinical nurse specialist and clinical research nurse. She holds a diploma in Cancer Nursing from The Royal Marsden as well as an MSc Advanced Nursing Practice – Cancer from King’s College.

Flora’s areas of special interest include patient advocacy, voluntary work supporting leukaemia and myeloma charities.

“The most rewarding part of my job is improving patient experience by working with patients, their families and carers so that they feel informed, supported and cared for at all times.”

Claire Nicholas, Lead Clinical Nurse Specialist

Claire is the lead clinical nurse specialist for haematology. She manages a team of 10 clinical nurse specialists and a Macmillan cancer support worker. She has worked as a clinical nurse specialist in a number of haematology specialties, and has a particular interest in chronic myeloid leukaemia. She is focused on providing better patient information, and is currently leading on a project which has standardised written information for newly diagnosed patients receiving care in the London Cancer hospital network.

“The most enjoyable part of my role at UCLH is leading an innovative, effective and supportive team of clinical nurse specialists. We embrace new ways of working, developing additional services and perform strongly in patient surveys”


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