Abstract
INTRODUCTION: Patients with chronic myeloproliferative neoplasms (MPNs) have upregulated renin-angiotensin-aldosteron system in the bone marrow and suffer from debilitating inflammation-linked symptoms. The use of angiotensin-converting enzyme inhibitors (ACEi) has been shown to improve hematocrit control and thrombotic risk in MPNs. Here, we investigated whether ACEi use may also have an impact on disease-related symptoms in MPNs. PATIENTS AND METHODS: This cross-sectional two-center study included 100 consecutive MPN patients who fulfilled the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF) at the time of study entry. RESULTS: The use of ACEi correlated with older age, presence of JAK2 mutation, prior thrombosis and different cardiovascular risk factors. Patients using ACEi also presented with higher total symptom score (p = 0.002), more abdominal discomfort (p = 0.031), concentration problems (p = 0.050) and bone pains (p = 0.001). To account for baseline variables that may have potentially impacted MPN symptom control, ACEi users and non-users were case-matched in a 1:1 ratio with respect to sex, age, cytoreductive treatment, and cardiovascular risk factors. Again, there were no differences in almost all MPN-SAF items with respect to ACEi use (p > 0.050 for all analyses). CONCLUSION: The use of ACEi does not seem to mitigate disease-related symptoms in MPNs. Prospective randomized trials are needed to fully elucidate their therapeutic potential in MPNs.