Patients with early-stage myelofibrosis (MF) suffer less damage to quality of life compared with those who have overt disease, but they nevertheless have a high prevalence of symptoms, according to an observational study presented at the 65th ASH Annual Meeting and Exposition by Giovanni Caocci, MD, of the University of Cagliari, Businco Hospital in Italy, and colleagues.
The study included 104 MF patients recruited from community and university hospitals. Researchers with the Gruppo Italiano Malattie e Matologiche dell’Adulto (GIMEMA) assessed health-related quality of life (HRQOL), including symptom severity, with the EORTC QLQ-C30, a 30-item instrument. They assessed prevalence of symptoms with the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score, a 10-item questionnaire. Of the total sample, 35 patients had pre-fibrotic MF, which is associated with grade 0–1 reticulin fibrosis, and 69 had overt MF, meaning grade 2–3 reticulin and/or collagen fibrosis.
Based on EORTC QLQ-C30 scores, compared with the pre-fibrotic cohort, patients with overt MF had statistically and clinically meaningful worse global HRQOL (Δ=11.4), with role functioning, cognitive functioning, and social functioning particularly affected.
Patients with overt MF generally had more severe symptoms than those with pre-fibrotic MF, but the researchers said that the high prevalence of symptoms in patients with pre-fibrotic MF is noteworthy. For example, the most commonly reported symptom, severe fatigue, was reported in 83% of patients with pre-fibrotic MF, 75% of those with overt MF, and 78% of the overall sample, GIMEMA researchers reported (see TABLE).
| TABLE. Prevalence (%) of Symptoms in MF per MPN Symptom Assessment Form Total Symptom Score | |||
| Symptom | Prefibrotic MF (n=35) | Overt MF (n=69) | Overall MF population (n=104) |
| Worst fatigue (worst imaginable, as bad as it can be) | 83% | 75% | 78% |
| Concentration problems | 54% | 52% | 53% |
| Inactivity | 37% | 57% | 50% |
| Early satiety | 40% | 52% | 49% |
| Abdominal discomfort | 43% | 36% | 39% |
| Night sweats | 29% | 41% | 36% |
| Itching | 31% | 38% | 36% |
| Bone pain | 34% | 38% | 36% |
| Weight loss | 11% | 33% | 26% |
| Fever | 0 | 4% | 3% |
References
Barbui T, Thiele J, Gisslinger H, et al. The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion. Blood Cancer J. 2018;8(2):15.
Caocci G, Palandri F, Loscocco GG, et al. Health-related quality of life and symptom burden profile of patients with pre-fibrotic and overt myelofibrosis: a preliminary report from the GIMEMA–Prophecy observational study. Abstract #2441. Presented at the 65th ASH Annual Meeting and Exposition; December 9-12; San Diego, California.
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