Abstract
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.