Cancer medicine · 2025
Predictors of Symptom Scores in Myeloproliferative Neoplasms: A Real-World Retrospective Cohort Study.
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Khan Muhammad Ali, Naqvi Syed Arsalan Ahmed, Camoriano John K, Arana Yi Cecilia Y, Andres Jennifer T, Blocher Joshua L, Kosiorek Heidi E, Riaz Irbaz Bin, Palmer Jeanne M
Аннотация
BACKGROUND: Symptom management in myeloproliferative neoplasms (MPN) remains challenging despite advancements in disease-directed therapies. This study assessed the impact of demographic, clinical, laboratory and treatment-related variables on total symptom scores (TSS) and individual symptom scores in patients with polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF).
METHODS: A cohort of 553 patients (PV: 200; ET: 190; MF: 163) was identified through a retrospective chart review. Symptom scores, demographic information and clinical variables were captured at the time of the first TSS assessment. Laboratory results within 1 month and treatment information within 90 days prior to the symptom assessment were captured. Univariable linear regression, followed by multivariable regression analyses using a robust variance estimator were performed, with a p value < 0.05 indicating a significant association.
RESULTS: MF patients experienced the highest symptom burden and fatigue was the most reported symptom across all MPN subtypes. In PV, depression (β: 10.53; p = 0.001) was associated with a higher TSS whereas older age (-0.17; 0.01) and higher hemoglobin (-1.24; 0.003) were associated with a lower TSS. In ET, depression (β: 14.19; p < 0.001) was associated with a higher TSS, whereas in MF, depression (12.28; < 0.001) and higher WBC count (0.22; 0.02) were associated with a higher TSS. Depression and non-White race in PV, depression in ET, and depression, low hemoglobin, and higher WBC count in MF were associated with multiple symptoms.
CONCLUSIONS: Integrating depression screening and management and optimizing hematologic parameters alongside disease-directed therapy is crucial to improving patient outcomes.
METHODS: A cohort of 553 patients (PV: 200; ET: 190; MF: 163) was identified through a retrospective chart review. Symptom scores, demographic information and clinical variables were captured at the time of the first TSS assessment. Laboratory results within 1 month and treatment information within 90 days prior to the symptom assessment were captured. Univariable linear regression, followed by multivariable regression analyses using a robust variance estimator were performed, with a p value < 0.05 indicating a significant association.
RESULTS: MF patients experienced the highest symptom burden and fatigue was the most reported symptom across all MPN subtypes. In PV, depression (β: 10.53; p = 0.001) was associated with a higher TSS whereas older age (-0.17; 0.01) and higher hemoglobin (-1.24; 0.003) were associated with a lower TSS. In ET, depression (β: 14.19; p < 0.001) was associated with a higher TSS, whereas in MF, depression (12.28; < 0.001) and higher WBC count (0.22; 0.02) were associated with a higher TSS. Depression and non-White race in PV, depression in ET, and depression, low hemoglobin, and higher WBC count in MF were associated with multiple symptoms.
CONCLUSIONS: Integrating depression screening and management and optimizing hematologic parameters alongside disease-directed therapy is crucial to improving patient outcomes.