Psychological Symptoms Among Patients With BCR-ABL-Negative Myeloproliferative Neoplasms

J Natl Compr Canc Netw. 2016 Dec;14(12):1563-1570. doi: 10.6004/jnccn.2016.0168.

Abstract

Background: BCR-ABL-negative myeloproliferative neoplasms (MPNs) represent a heterogeneous group of diseases, including essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF). Psychological manifestations among these diseases have not been adequately described.

Methods: Cross-sectional surveys measuring distress, anxiety, and depression were collected from patients with BCR-ABL-negative MPNs from May 2015 to October 2015. Participants provided demographic information and completed the Distress Thermometer and Problem List (DT&PL) to assess distress and the Hospital Anxiety and Depression Scale (HADS) to assess distress, anxiety, and depression. They provided information on how their MPN affected their lives.

Results: Of the 117 participants, 31.2% had PV, 28.4% had ET, 28.4% had MF, and 11.9% had another type of MPN. Time with MPN varied from less than 1 year (7.5%), 1 to 3 years (19.8%), 3 to 5 years (23.6%), 5 to 10 years (19.8%), and more than 10 years (29.2%). Distress averaged 3.14 (SD, 2.83; DT&PL), with 40.4% meeting NCCN criteria for distress, and averaged 8.97 (SD, 7.44; HADS), with 38.5% meeting HADS criteria for distress. Anxiety averaged 5.54 (SD, 4.37), with 31.3% meeting HADS criteria for anxiety. Depression averaged 3.4 (SD, 3.4), with 12.5% meeting HADS criteria for depression. Distress was higher for PV (3.86), MF (3.12), and "other" MPN (4.33) than it was for ET (1.81; P=.016). Distress was more common in non-white patients (P=.015) and those with either PV or MF but not ET (DT&PL ≥4; P=.038). Patients' comments described coping strategies or symptom burden.

Conclusions: Distress and anxiety are highly prevalent with BCR-ABL-negative MPNs and may correspond to disease-related symptom burden. These findings deserve further study.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antidepressive Agents / therapeutic use
  • Anxiety / drug therapy
  • Anxiety / epidemiology*
  • Cross-Sectional Studies
  • Depression / drug therapy
  • Depression / epidemiology*
  • Female
  • Fusion Proteins, bcr-abl / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Polycythemia Vera / metabolism
  • Polycythemia Vera / psychology*
  • Prevalence
  • Primary Myelofibrosis / metabolism
  • Primary Myelofibrosis / psychology*
  • Sex Factors
  • Stress, Psychological / drug therapy
  • Stress, Psychological / epidemiology*
  • Thrombocythemia, Essential / metabolism
  • Thrombocythemia, Essential / psychology*
  • Time Factors

Substances

  • Antidepressive Agents
  • Fusion Proteins, bcr-abl