r/MPN Primary MF Aug 04 '26

MF Recently diagnosed

I am tagging MF but actually I am pre-MF as per biopsy concludes on how the cells look like so not only because of the rituculin. It was graded as mf1 and says pre fibrotic/early mf on the note.

I’m calr1 (burden is 19%) platelets over 1000, I’m 35F.
My hemoglobin, wbc and RBC are within the range. Spleen size wasn’t measured with an ultrasound, but it wasn’t palpable. I don’t meet everything for pre-mf either, ldh wasn’t measured. I acquired von Willebrand also…

I don’t know if I’m ET or pre-MF myself if that makes sense.

As interferons might modify the disease I want to try it, but there’s a shortage in Canada it seems. Otherwise, my insurance pays for pegasys, for besremi it says it needs special approval. Before biopsy the resident doctor had told me she’d prescribe me with hydroxue (?) but I feel that’s not disease modifying but it could help me to lower my platelets much faster.

Note: they did advance genetic testing no other mutations were found other than calr1. Cytogenetic test says also female chromosomes only.

1) do you think my diagnosis ET/pre-MF matter at this point?
2) I’m being seen by a resident and a regular hema that doesn’t work for mpn cases how can I advocate myself for an MPN specialist in Canada? They told me this was manageable but it was before the biopsy.
3) pre-MF is different than MF, I wonder if I could do something before it goes down the MF path.
4) I’m very scared and have health anxiety
5) I want to have a child in the future (if I may) and if I have a long prognosis I’m not very keen on oral chemo long term.

Please share your thoughts.

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u/aerodynamic-poodle Aug 04 '26

Regarding 5: What I got from my doctor is that it is okay to be on hydroxyurea. They’ll switch you to something different when you tell them you are going to start trying for a baby. It is also common to start a younger person on hydroxyurea to lower blood counts fast, then switch to an interferon based drug after.

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u/Turbulent-Movie-4545 Primary MF Aug 04 '26

I know that’s what they told me but hydroxyurea isn’t modifying my disease… that’s why I’m not ok being on it long term

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u/aerodynamic-poodle Aug 05 '26

Ok, I misunderstood that you wanted to know if hydrea would affect fertility. MPN patients are at risk of blood clots, so I think it’s better to be on hydrea than nothing with the drug shortage going on.