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. 2021 Jun 10;21(1):691.
doi: 10.1186/s12885-021-08439-7.

Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care

Sarah F Christensen  1 , Robyn M Scherber  2   3 , Gina L Mazza  4 , Amylou C Dueck  4 , Nana Brochmann  5 , Christen L Andersen  6 , Hans C Hasselbalch  5 , Ruben A Mesa  2 , Holly L Geyer  7
Affiliations

Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care

Sarah F Christensen et al. BMC Cancer. .

Abstract

Background: Patients with Philadelphia-negative Myeloproliferative Neoplasms (MPN) suffer from numerous symptoms and decreased quality of life. Smoking is associated with an increased symptom burden in several malignancies. The aim of this study was to analyze the association between smoking and MPN-related symptom burden and explore MPN patients' opinions on smoking.

Methods: A total of 435 patients with MPN participated in a cross-sectional internet-based survey developed by the Mayo Clinic and the Myeloproliferative Neoplasm Quality of Life Group. Patients reported their demographics, disease characteristics, tobacco use, and opinions on tobacco use. In addition, MPN-related symptoms were reported via the validated 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form.

Results: Current/former smokers reported worse fatigue (mean severity 5.6 vs. 5.0, p = 0.02) and inactivity (mean severity 4.0 vs. 3.4, p = 0.03) than never smokers. Moreover, current/former smokers more frequently experienced early satiety (68.5% vs. 58.3%, p = 0.03), inactivity (79.9% vs. 71.1%, p = 0.04), and concentration difficulties (82.1% vs. 73.1%, p = 0.04). Although not significant, a higher total symptom burden was observed for current/former smokers (mean 30.4 vs. 27.0, p = 0.07). Accordingly, overall quality of life was significantly better among never smokers than current/former smokers (mean 3.5 vs. 3.9, p = 0.03). Only 43.2% of the current/former smokers reported having discussed tobacco use with their physician, and 17.5% did not believe smoking increased the risk of thrombosis.

Conclusion: The current study suggests that smoking may be associated with increased prevalence and severity of MPN symptoms and underscores the need to enhance patient education and address tobacco use in the care of MPN patients.

Keywords: Cross-sectional internet-based survey; Myeloproliferative neoplasms; Quality of life; Symptom burden; Tobacco use.

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Conflict of interest statement

Ruben Mesa: Consultant - Novartis, Sierra, La Jolla, Pharma; Research Support – Incyte, CTI, Celgene, Abbvie, Samus, Promedior, Genetech; Robyn Scherber: Employment – Incyte; Hans Hasselbalch: Consultant – Novartis; Advisory Board – AOP Orphan; Research Grant – Novartis.

Figures

Fig. 1
Fig. 1
Symptom Severity and Prevalence by Smoking Status. Comparison of mean scores for individual MPN-10 items and quality of life between current/formers smokers and never smokers; a Symptom severity was measured on a 0 (absent) to 10 (worst imaginable) scale. Quality of life was measured on a 0 (as good as it can be) to 10 (as bad as it can be) scale; b Prevalence was defined as a symptom score greater than or equal to 1. *p-value < 0.05
Fig. 2
Fig. 2
Total Symptom Score (TSS) by Smoking Status and MPN subtype. Comparison of TSS between current/formers smokers and never smokers by MPN subtype. The TSS was calculated for all respondents completing at least six of the 10 MPN-10 items. MPN: Philadelphia-negative chronic myeloproliferative neoplasms; ET: essential thrombocythemia; PV: polycythemia vera; MF: myelofibrosis. No significant mean differences were observed, though p = 0.07 for All MPN and p = 0.06 for PV
Fig. 3
Fig. 3
Symptom Severity and Prevalence by Smoking and MPN subtype. Comparison of mean severity (a) and prevalence (b) for individual MPN-10 items and quality of life between current/formers smokers and never smokers by MPN subtype. Symptom severity was measured on a 0 (absent) to 10 (worst imaginable) scale. Quality of life was measured on a 0 (as good as it can be) to 10 (as bad as it can be) scale. Prevalence was defined as a symptom score greater than or equal to 1. *p-value < 0.05. MPN: Philadelphia-negative chronic myeloproliferative neoplasms; ET: essential thrombocythemia; PV: polycythemia vera; MF: myelofibrosis
See this image and copyright information in PMC

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