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Haematologica. 2017 Jan;102(1):85-93. doi: 10.3324/haematol.2016.149559. Epub 2016 Aug 18.

Associations between gender, disease features and symptom burden in patients with myeloproliferative neoplasms: an analysis by the MPN QOL International Working Group.

Author information

1
Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA mesa.ruben@mayo.edu geyer.holly@mayo.edu.
2
Section of Biostatistics, Mayo Clinic, Scottsdale, AZ, USA.
3
Oregon Health Sciences University, Portland, OR, USA.
4
Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands.
5
Department of Hematology, Erasmus MC, Rotterdam, the Netherlands.
6
MPN Forum, Ashville, NC, USA.
7
Department of Hematology, MUMC, Maastricht, the Netherlands.
8
Fundaleu, Buenos Aires, Argentina.
9
Department of Haematology, University Hospital La Paz, Madrid, Spain.
10
Department of Molecular Hematology, University Hospital Freiburg, Germany.
11
Johannes Wesling Klinikum, Minden, Germany.
12
Department of Internal Medicine III, University Hospital of Ulm, Germany.
13
Hematology Department, University Hospital, Basel, Switzerland.
14
Medizinische Klinik, Universitätsmedizin, Mannheim, Germany.
15
Centre Hospitalier Universitaire, Angers, France.
16
Institut Bergonie, Bordeaux, France.
17
Centre Hospitalier Universitaire, Brest, France.
18
Hospitalier Universitaire, Nancy, France.
19
Centre Hospitalier Universitaire, Poitiers, France.
20
Centre Hospitalier Universitaire, Grenoble, France.
21
Department of Haematology, Guy's and St. Thomas NHS Foundation Trust, London, UK.
22
Unidadde Hematología, Hospital Británico, Montevideo, Uruguay.
23
University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
24
Hematology Department, Hospital del Mar, Barcelona, Spain.
25
Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Spain.
26
Internal Medicine, NU Hospital Organization, Uddevalla, Sweden.
27
Research Foundation (FROM), Hospital Papa Giovanni XXIII, Bergamo, Italy.
28
Laboratory of Clinical Epidemiology, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
29
Center for Research and Innovation of Myeloproliferative Neoplasms, University of Florence, Italy.
30
Ematologia, Dipartimento di Medicina Clinica e Sperimentale, University of Insubria, Varese, Italy.
31
Biol. Sci., Ospedali Riuniti di Bergamo, Italy.
32
Department of Internal Medicine, Stockholm South Hospital, Sweden.
33
Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.
34
Department of Hematology, University Hospital, Uppsala, Sweden.
35
MDS and MPN Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
36
Clinical Investigation Center, Hospital Saint-Louis, Paris, France.
37
Department of Pathology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
38
Imperial College, London, UK.
39
Department of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA mesa.ruben@mayo.edu geyer.holly@mayo.edu.

Abstract

The myeloproliferative neoplasms, including polycythemia vera, essential thrombocythemia and myelofibrosis, are distinguished by their debilitating symptom profiles, life-threatening complications and profound impact on quality of life. The role gender plays in the symptomatology of myeloproliferative neoplasms remains under-investigated. In this study we evaluated how gender relates to patients' characteristics, disease complications and overall symptom expression. A total of 2,006 patients (polycythemia vera=711, essential thrombocythemia=830, myelofibrosis=460, unknown=5) were prospectively evaluated, with patients completing the Myeloproliferative Neoplasm-Symptom Assessment Form and Brief Fatigue Inventory Patient Reported Outcome tools. Information on the individual patients' characteristics, disease complications and laboratory data was collected. Consistent with known literature, most female patients were more likely to have essential thrombocythemia (48.6% versus 33.0%; P<0.001) and most male patients were more likely to have polycythemia vera (41.8% versus 30.3%; P<0.001). The rate of thrombocytopenia was higher among males than females (13.9% versus 8.2%; P<0.001) and males also had greater red-blood cell transfusion requirements (7.3% versus 4.9%; P=0.02) with shorter mean disease duration (6.4 versus 7.2 years, P=0.03). Despite there being no statistical differences in risk scores, receipt of most therapies or prior complications (hemorrhage, thrombosis), females had more severe and more frequent symptoms for most individual symptoms, along with overall total symptom score (22.8 versus 20.3; P<0.001). Females had particularly high scores for abdominal-related symptoms (abdominal pain/discomfort) and microvascular symptoms (headache, fatigue, insomnia, concentration difficulties, dizziness; all P<0.01). Despite complaining of more severe symptom burden, females had similar quality of life scores to those of males. The results of this study suggest that gender contributes to the heterogeneity of myeloproliferative neoplasms by influencing phenotypic profiles and symptom expression.

PMID:
27540137
PMCID:
PMC5210236
DOI:
10.3324/haematol.2016.149559
[Indexed for MEDLINE]
Free PMC Article

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