QoL in MPN: physical, psychological, and social impacts

During the course of disease and subsequent treatment many patients with myeloproliferative neoplasms (MPN) report impacts on their quality of life (QoL). Previous studies have identified these impacts; however, there has been no comprehensive investigation in specific areas of patients’ life. Here, we summarize results from a survey investigating the physical, psychological, and social impacts of MPN by Eppingbroek et al.¹ published in Psycho-oncology.  

Study design¹

Patients with MPN were assessed for: 

• MPN symptoms, using the MPN Symptom Assessment Form total symptom score (Figure 1); 
• QoL, using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire; and 
• Disease-related factors, from a questionnaire on diagnosis, disease status, treatment(s), adverse events, and comorbidities.

*Adapted from Eppingbroek AAM, et al.^1
†Functional scales.
^‡Symptom scales.

 Key findings¹  

• Overall, 455 patients with MPN who had not received allo-SCT were recruited
• Patients were invited to answer an online survey between November 2022 and February 2023
• The mean age was 63.01 years
• 63.7% of patients were female
• 45.7% of patients were diagnosed with polycythemia vera, 17.1% with myelofibrosis, and 37.2% with essential thrombocytopenia 
• Treatment options included ‘wait-and-see', phlebotomy, cytoreduction, and combined phlebotomy, and cytoreduction

Symptom burden and QoL¹

• Overall, 97.4% of patients reported symptoms.
• European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire scores for the most highly scored impacts in each category are outlined in Table 1.

Table 1. EORTC QLQ-C30 assessment scores for MPN patients*

EORTC QLQ-C30, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire; MPN, myeloproliferative neoplasms. *Data from Eppingbroek, et al.1
Category	QoL impact	EORTC QLQ-C30 score
Physical	Fatigue	44.3
	Insomnia	36.0
Psychological	Cognitive function	77.1
	Emotional function	66.6
	Concentration	74.7
Social	Social and role function	70.9

• In comparison with other cancers, patients with MPN reported fewer financial difficulties (9.9 vs 16.3) and appetite loss symptoms (10.8 vs 21.1); 48.8% of patients reported that MPN symptoms impacted on their work life. 

• An increased number of reported adverse events correlated with a decrease in QoL.
  • The group of patients who reported symptoms impacting working life had higher symptom burden and lower QoL compared with patients who did not (58.1 vs 69.8).
• MPN subtype and treatment option did not significantly change MPN symptom burden on QoL.

Key learnings
MPN negatively impacts several QoL domains. Fatigue and problems relating to cognitive function were the highest scoring factors. Future research should investigate ways to relieve fatigue and reduced cognitive function in patients with MPN to improve their QoL.