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. 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

Holly L Geyer  1 , Heidi Kosiorek  2 , Amylou C Dueck  2 , Robyn Scherber  3 , Stefanie Slot  4 , Sonja Zweegman  4 , Peter Aw Te Boekhorst  5 , Zhenya Senyak  6 , Harry C Schouten  7 , Federico Sackmann  8 , Ana Kerguelen Fuentes  9 , Dolores Hernández-Maraver  9 , Heike L Pahl  10 , Martin Griesshammer  11 , Frank Stegelmann  12 , Konstanze Döhner  12 , Thomas Lehmann  13 , Karin Bonatz  14 , Andreas Reiter  14 , Francoise Boyer  15 , Gabriel Etienne  16 , Jean-Christophe Ianotto  17 , Dana Ranta  18 , Lydia Roy  19 , Jean-Yves Cahn  20 , Claire N Harrison  21 , Deepti Radia  21 , Pablo Muxi  22 , Norman Maldonado  23 , Carlos Besses  24 , Francisco Cervantes  25 , Peter L Johansson  26 , Tiziano Barbui  27 , Giovanni Barosi  28 , Alessandro M Vannucchi  29 , Chiara Paoli  29 , Francesco Passamonti  30 , Bjorn Andreasson  26 , Maria L Ferrari  31 , Alessandro Rambaldi  27 , Jan Samuelsson  32 , Keith Cannon  33 , Gunnar Birgegard  34 , Zhijian Xiao  35 , Zefeng Xu  35 , Yue Zhang  35 , Xiujuan Sun  35 , Junqing Xu  35 , Jean-Jacques Kiladjian  36 , Peihong Zhang  37 , Robert Peter Gale  38 , Ruben A Mesa  39
Affiliations

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

Holly L Geyer et al. Haematologica. 2017 Jan.

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.

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Figures

Figure 1.
Figure 1.
Percentage of MPN patients who have received prior therapies (x axis) compared by gender.
Figure 2.
Figure 2.
Distribution of MPN-SAF scores according to age in females (top) and males (bottom) Evaluation of total number of patients in each gender (y axis) when compared by total MPN-SAF TSS value (x axis).
Figure 3.
Figure 3.
Comparison of scores for the individual items of the MPN-SAF between males and females.
Figure 4.
Figure 4.
Comparison of the prevalence of MPN-SAF symptoms between males and females.
Figure 5.
Figure 5.
Comparison of scores for individual MPN-SAF items between Chinese and Western females.
Figure 6.
Figure 6.
Comparison of scores for individual MPN-SAF items between Chinese and Western males.
See this image and copyright information in PMC

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