Study Investigates Quality of Life in Patients With MPNs

While there has been much clinical research into the treatment methods of myeloproliferative neoplasms (MPNs), there is significantly less regarding the quality of life of patients who have this class of disease.

Researchers from around the world collaborated on the MEASURE trial to better understand the symptomatic response to MPN therapies. Their interim findings were presented at the 2018 American Society of Hematology Annual Meeting.

“Myeloproliferative neoplasms are associated with burdensome symptoms that significantly compromise quality of life,” researchers wrote. “To date, no studies have quantified symptomatic response to standard-of-care treatments.”

The study included 270 patients with MPNs — 155 had essential thrombocythemia, 75 had polycythemia vera and 30 had myelofibrosis. Patients were asked to fill out quality of life questionnaires at the start of the study, and again at three and six months. They were assessed using three different tools: MPN Symptom Assessment Form — Total Symptom Score; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30; and the MD Anderson Symptom Inventory. The questionnaires are all measured tools to examine symptom burden and quality of life.

Common pre-trial enrollment therapies included aspirin (34 percent), phlebotomy (15 percent) hydroxyurea (14 percent) and warfarin/clopidogrel/anticoagulation (6 percent). Once enrolled and in treatment, the most common MPN treatments that participants had were hydroxyurea (67 percent), aspirin (24 percent) phlebotomy (9 percent) and Jakafi (ruxolitinib; 8 percent).

Researchers found no significant changes in most symptoms, including early satiety, abdominal discomfort, night sweats, fatigue, inactivity, poor concentration, bone pain, itching and fever. There were also no drastic changes in emotional, physical, cognitive or social functioning.

However, there were some exceptions, with patients reporting significant weight loss and worsening quality of life.

“Overall, results from the MEASURE study suggest that standard treatments have limited systematic impact on patient symptomology over time, with no improvements in the overall quality of life,” researchers wrote.

Since only 8 percent of participants were prescribed Jakafi, the researchers also pointed toward the need for further investigation.

“However, we note the relatively low proportion of patients in this cohort treated with ruxolitinib, which has been shown previously to improve symptom burden, and this may have impacted the symptom responses seen in the group as a whole,” researchers wrote.