Mesa Ruben A, Niblack Joyce, Wadleigh Martha, Verstovsek Srdan, Camoriano John, Barnes Sunni, Tan Angelina D, Atherton Pamela J, Sloan Jeff A, Tefferi Ayalew
Department of Hematology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Cancer. 2007 Jan 1;109(1):68-76. doi: 10.1002/cncr.22365.
Few objective data exist on the burden of fatigue and other constitutional symptoms in patients with myeloproliferative disorders (MPD).
The authors used validated instruments of fatigue and physical activity assessment during an Internet-based symptom survey of 1179 MPD patients (median age, 56 years; 41.4% men).
The frequency of self-reporting was 80.7% for fatigue, which was substantially higher than that of pruritus (52.2%), night sweats (49.2%), bone pain (43.9%), fever (13.7%), and weight loss (13.1%). In the majority of patients, these symptoms restricted participation in both social functions and physical activity. In addition, 34.5% of patients needed assistance with activities of daily living, and 11.2% reported MPD-associated medical disability. As expected, the presence of myelofibrosis, anemia, splenomegaly, or other features associated with advanced disease favored a higher degree of fatigue. However, fatigue remained the major complaint also in polycythemia vera (84.9%) and essential thrombocythemia (72.4%); these figures were significantly higher than those of published controls (P < .0001).
The current study identifies fatigue as the major contributor to poor quality of life in MPD, provides baseline information on constitutional symptoms, and underscores the need for the incorporation of quality of life assessment in clinical trials.
关于骨髓增殖性疾病(MPD)患者疲劳及其他体质性症状负担的客观数据较少。
作者在一项基于互联网的对1179例MPD患者(中位年龄56岁;41.4%为男性)的症状调查中,使用了经过验证的疲劳和身体活动评估工具。
疲劳的自我报告频率为80.7%,显著高于瘙痒(52.2%)、盗汗(49.2%)、骨痛(43.9%)、发热(13.7%)和体重减轻(13.1%)。在大多数患者中,这些症状限制了他们参与社交活动和体育活动。此外,34.5%的患者在日常生活活动中需要帮助,11.2%的患者报告有与MPD相关的医疗残疾。正如预期的那样,骨髓纤维化、贫血、脾肿大或其他与晚期疾病相关的特征的存在,更易导致较高程度的疲劳。然而,疲劳仍是真性红细胞增多症(84.9%)和原发性血小板增多症(72.4%)患者的主要主诉;这些数字显著高于已发表的对照数据(P <.0001)。
当前研究确定疲劳是MPD患者生活质量差的主要因素,提供了关于体质性症状的基线信息,并强调在临床试验中纳入生活质量评估的必要性。