Management of fatigue in patients treated for myeloproliferative neoplasms (MPNs) should include a comprehensive assessment and treatment plan in order to address modifiable etiologies, according to a recent study published online ahead of print in Cancer.1

Robyn Scherber MD, MPH, of the Mayo Clinic in Scottsdale, AZ, developed a 70-item, Internet-based survey regarding fatigue that was hosted by the Mayo Clinic Survey Research Center.

“Patients with MPNs experience a high persistence, prevalence, and severity of fatigue,” the authors noted. “There is currently only limited information regarding factors that contribute to fatigue in patients with MPNs.”


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From a total of 1788 respondents, the authors found that higher body mass index, current use of alcohol, and current tobacco use were significantly associated with greater fatigue. Moderate to severe fatigue was found to be present more frequently in patients who did not exercise compared to those who reported exercising at least once a week.

They also found that medical comorbidities, which included: restless leg syndrome, diabetes mellitus, fibromyalgia, chronic fatigue syndrome, and chronic kidney disease, were significantly associated with greater fatigue.

Current use of antidepressants, antihistamines, antianxiety medication and prescription pain medication were found to be associated with worsened fatigue.

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Additionally, nearly 25% of respondents score greater than 2 on the Patient Health Questionnaire, which indicated a high probability of depression, and a higher Brief Fatigue Inventory score, Myeloproliferative Neoplasm Total Symptom Score as well as individual symptom items were all associated with a higher likelihood of depressive symptoms.

“Patients with MPNs likely have a higher prevalence of mood disturbances compared with the general population, suggesting the need to assess and intervene in this domain,” the authors concluded.

Reference

  1. Scherber RM, Kosiorek HE, Senyak Z, et al. Comprehensively understanding fatigue in patients with myeloproliferative neoplasms [published online ahead of print December 15, 2015]. Cancer. doi: 10.1002/cncr.29753.