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. 2020 Aug 6;12(8):2202.
doi: 10.3390/cancers12082202.

Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association

Sarah Friis Christensen  1 , Robyn Marie Scherber  2   3 , Nana Brochmann  1 , Martin Goros  4 , Jonathan Gelfond  4 , Christen Lykkegaard Andersen  5 , Esben Meulengracht Flachs  6 , Ruben Mesa  2
Affiliations

Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association

Sarah Friis Christensen et al. Cancers (Basel). .

Abstract

Elevated body mass index (BMI) is a global health problem, leading to enhanced mortality and the increased risk of several cancers including essential thrombocythemia (ET), a subtype of the Philadelphia-chromosome negative myeloproliferative neoplasms (MPN). Furthermore, evidence states that BMI is associated with the severity of symptom burden among cancer patients. MPN patients often suffer from severe symptom burden. The purpose of this study was to examine whether deviations from a normal BMI in an MPN population are associated with higher symptom burden and reduced quality of life (QoL). A combined analysis of two large cross-sectional surveys, the Danish Population-based Study, MPNhealthSurvey (n = 2044), and the international Fatigue Study (n = 1070), was performed. Symptoms and QoL were assessed using the validated Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF). Analysis of covariance was used to estimate the effects of different BMI categories on symptom scores while adjusting for age, sex, and MPN subtype. A U-shaped association between BMI and Total Symptom Burden was observed in both datasets with significantly higher mean scores for underweight and obese patients relative to normal weight (mean difference: underweight 5.51 (25.8%), p = 0.006; obese 5.70 (26.6%) p < 0.001). This is an important finding, as BMI is a potentially modifiable factor in the care of MPN patients.

Keywords: Philadelphia-negative myeloproliferative neoplasms (MPN), body mass index; chronic inflammation; quality of life; symptom burden.

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Conflict of interest statement

R.M.: Consultant—Novartis, Sierra, Blueprint, La Jolla; Research Support—Incyte, CTI, Celgene, Abbvie. R.M.S.: Employment—Incyte. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Association between Body Mass Index (BMI) and Total Symptom Score (TSS). TSS was calculated for all respondents completing at least six of 10 TSS survey items. A high score represents high total symptom burden: (a) combined data; (b) by study.
Figure 2
Figure 2
Association between BMI and TSS by MPN subtype (a) and gender (b), respectively. TSS was calculated for all respondents completing at least six of 10 TSS survey items. A high score represents high total symptom burden.
See this image and copyright information in PMC

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