Symptom Burden Higher Among Patients Receiving Hydroxyurea for MPN

Recent research presented at the 2022 American Society of Hematology Annual Meeting explored associations between symptom-related quality of life (QOL) and the type of cytoreductive treatment used for myeloproliferative neoplasms (MPNs). The analysis found that hydroxyurea and pegylated interferon-alpha-2 (IFNα) both increased symptom burden, but only patients who received hydroxyurea had higher total symptom scores at 36 months.

The authors, led by Trine A. Knudsen, MD, of the Department of Hematology at Zealand University Hospital in Roskilde, Denmark, analyzed data from the phase III DALIAH trial, involving adult patients newly diagnosed with MPN receiving hydroxyurea or IFNα. The patients rated their symptom burden and QOL on the Myeloproliferative Neoplasm Symptom Assessment Form, from a scale of zero (absent/as good as it can be) to 10 (worst-imaginable/as bad as it can be). They completed the self-assessment at baseline; then at four, eight, 12, 18, 24, and 30 months; and then for the final time at 36 months.

At baseline, a majority of patients (70%) reported at least one moderate or severe symptom, and almost half (46%) reported severe symptoms. Fatigue was the most common symptom (82%) and also the most intense. The next most common symptoms were lack of concentration (21%) and insomnia (20%). Findings were similar among patients receiving hydroxyurea and IFNα.

During treatment, 88% of patients completed the assessment tool at least once. Those receiving hydroxyurea reported worsening fatigue, abdominal pain and discomfort, problems with sexual function, itchiness, and bone pain.

Those receiving IFNα reported worsening fatigue, early satiety, abdominal pain and discomfort, inactivity, headache, difficulty concentration, numbness, dizziness, insomnia, problems with sexual function, cough, and itchiness.

At final follow-up, only those randomized to hydroxyurea had significantly higher total symptom scores compared to baseline.

Reference

Knudsen TA, Hansen DL, Ocias LF, et al. Quality of life and symptom burden of patients with MPN during treatment with hydroxyurea or pegylated interferon-alpha2: results from a randomized controlled trial. Abstract #743. Presented at the 64th American Society of Hematology Annual Meeting, December 10-13, 2022; New Orleans, Louisiana.