Hi Disneydad,
You know Myelofibrosis is a special disease and then it is a symptom, that is common in many diseases like MDS. These patients have fibrosis in the bone marrow.
Patients with the disease Myelofibrosis often have enlarged spleen like your mother, they can have extramedullary hematopoesis (blood is manufactured outside the bone marrow), low HB, low platelets and increased WBCs. Your mother has very high WBCs. Do you know anything about the blast cells (immature cells) in the bone marrow?
I have never read anything about extramedullary hematopoesis in the pleura - the spleen is a very common place for that.
She has mylodysplasia that is a symptom indicating MDS.
Perhaps your mother has both Myelofibrosis and MDS?
The first drug for Myelofibrosis has now been approved. It is a JAK2 inhibitor called Ruxolitinib. It can help both JAK2 positive and negative patients. The drug can decrease the spleen and constitutional symptoms like fever, fatigue and so on but it can cause suppression of the bone marrow and I don't think that drug could help your mother.
http://www.medscape.com/viewarticle/753682
Kind regards
Birgitta-A
72 yo, dx MDS initially 2006. Dx then changed to Myelofibrosis with very severe fibrosis. After one year dx changed back to MDS Interm-1. Good results with Thalidomide + Prednisone.