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性功能症状在骨髓增殖性肿瘤症状负担和生活质量中的作用:国际 MPN 生活质量研究组的分析。

The role of sexuality symptoms in myeloproliferative neoplasm symptom burden and quality of life: An analysis by the MPN QOL International Study Group.

机构信息

Division of Hospital Internal Medicine, Mayo Clinic, Scottsdale, Arizona.

Internal Medicine, NU Hospital Organization, Uddevalla, Sweden.

出版信息

Cancer. 2016 Jun 15;122(12):1888-96. doi: 10.1002/cncr.30013. Epub 2016 Apr 12.

Abstract

BACKGROUND

Patients with myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia, and myelofibrosis, are faced with oppressive symptom profiles that compromise daily functioning and quality of life. Among these symptoms, sexuality-related symptoms have emerged as particularly prominent and largely unaddressed. In the current study, the authors evaluated how sexuality symptoms from MPN relate to other patient characteristics, disease features, treatments, and symptoms.

METHODS

A total of 1971 patients with MPN (827 with essential thrombocythemia, 682 with polycythemia vera, 456 with myelofibrosis, and 6 classified as other) were prospectively evaluated and patient responses to the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ C30) were collected, along with information regarding individual disease characteristics and laboratory data. Sexuality scores were compared with an age-matched, healthy control population.

RESULTS

Overall, patients with MPN were found to have greater sexual dysfunction compared with the healthy population (MPN-SAF score of 3.6 vs 2.0; P<.001), with 64% of patients with MPN describing some degree of sexual dysfunction and 43% experiencing severe symptoms. The presence of sexual symptoms correlated closely with all domains of patient functionality (physical, social, cognitive, emotional, and role functioning) and were associated with a reduced quality of life. Sexual problems also were found to be associated with other MPN symptoms, particularly depression and nocturnal and microvascular-related symptoms. Sexual dysfunction was more severe in patients aged >65 years and in those with cytopenias and transfusion requirements, and those receiving certain therapies such as immunomodulators or steroids.

CONCLUSIONS

The results of the current study identify the topic of sexuality as a prominent issue for the MPN population, and this area would appear to benefit from additional investigation and management. Cancer 2016;122:1888-96. © 2016 American Cancer Society.

摘要

背景

患有骨髓增生性肿瘤(MPN)的患者,包括真性红细胞增多症、原发性血小板增多症和骨髓纤维化,面临着压迫性症状,这些症状影响了他们的日常功能和生活质量。在这些症状中,与性行为相关的症状尤为突出,且在很大程度上未得到解决。在目前的研究中,作者评估了 MPN 的性行为症状与其他患者特征、疾病特征、治疗和症状之间的关系。

方法

共前瞻性评估了 1971 例 MPN 患者(827 例原发性血小板增多症、682 例真性红细胞增多症、456 例骨髓纤维化和 6 例其他),收集了患者对骨髓增生性肿瘤症状评估表(MPN-SAF)和欧洲癌症研究与治疗组织生活质量问卷核心 30 项(EORTC-QLQ C30)的反应,并收集了个体疾病特征和实验室数据。将性行为评分与年龄匹配的健康对照人群进行比较。

结果

总体而言,与健康人群相比,MPN 患者的性功能障碍更为严重(MPN-SAF 评分 3.6 对 2.0;P<.001),64%的 MPN 患者描述了一定程度的性功能障碍,43%的患者出现严重症状。性功能症状与患者所有功能领域(身体、社会、认知、情感和角色功能)密切相关,并与生活质量下降有关。还发现性功能障碍与其他 MPN 症状相关,特别是与抑郁、夜间和微血管相关症状相关。性功能障碍在年龄>65 岁的患者、有细胞减少和输血需求的患者以及接受免疫调节剂或类固醇等特定治疗的患者中更为严重。

结论

目前研究的结果确定了性行为是 MPN 人群的一个突出问题,这一领域似乎需要进一步的调查和管理。癌症 2016;122:1888-96。©2016 美国癌症协会。

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