Predictors of Symptom Scores in Myeloproliferative Neoplasms: A Real-World Retrospective Cohort Study

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).

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.

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.

Integrating depression screening and management and optimizing hematologic parameters alongside disease-directed therapy is crucial to improving patient outcomes.