Distress and anxiety are highly prevalent with BCR-ABL-negative MPNs and may correspond to disease-related symptom burden. These findings deserve further study.
Physical symptom burden in MPN patients was clearly associated with psychologic symptoms. Depression was uniquely associated with overall physical symptom burden. As such, the endorsement of multiple PPL items on the Distress Thermometer and Problem List should prompt an evaluation for psychologic symptoms to improve MPN patients' overall morbidity and quality of life.
Background
Patients with myeloproliferative neoplasms (MPNs) can have severe
physical symptom burden over an extended disease trajectory that contributes
to decreased quality of life. Few studies, however, have characterized for
which MPN patients physical symptoms are most frequently considered a
problem. As such, this study describes MPN patients' physical
symptoms and their relationship with patient characteristics.
Methods
Patients (N=117) with MPNs completed
questionnaires in a dedicated academic medical center MPN clinic. Patients
reported demographics (age, race/ethnicity, gender, marital status,
employment status) and disease characteristics (MPN type, time with MPN).
Patients reported whether they were bothered by any of 22 Physical Problem
List variables from the Distress Thermometer and Problem List
(DT&PL).
Results
The median number of physical problems endorsed by patients was 2
(M=2.26, SD=3.18) with a range from 0
to 20. Two-fifths endorsed no physical problems, one-fifth endorsed one
problem, and two-fifths endorsed 2 or more problems. Fatigue
(35.5%), sleep (27.1%), pain (21.5%), dry
skin/pruritus (18.7%), and memory/concentration (16.8%) were
the most commonly reported. Non-Caucasian participants reported more
problems with sleep (p=.050), pain (p=.016), and tingling
(p=.026). Polycythemia vera (PV) patients reported more issues with
tingling (p=.046) and sexual problems (p=.032).
Conclusion
It is more likely among patients with MPN to report physical symptom
bother than to report no bother with multiple physical problems on the
DT&PL. Patients of minority race/ethnicity and those with PV,
however, showed heightened prevalence of physical problems, characteristics
which may be used to triage patients for more intensive symptom
management.
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