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BCR-ABL 阴性骨髓增殖性肿瘤患者的心理症状。

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

机构信息

From Division of Network Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, West Harrison; Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai Hospital, New York; and Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.

出版信息

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.

摘要

背景

BCR-ABL 阴性骨髓增殖性肿瘤(MPN)是一组异质性疾病,包括原发性血小板增多症(ET)、真性红细胞增多症(PV)和骨髓纤维化(MF)。这些疾病中的心理表现尚未得到充分描述。

方法

2015 年 5 月至 10 月期间,从 BCR-ABL 阴性 MPN 患者中采集了测量痛苦、焦虑和抑郁的横断面调查。参与者提供了人口统计学信息,并完成了痛苦温度计和问题清单(DT&PL)以评估痛苦,以及医院焦虑和抑郁量表(HADS)以评估痛苦、焦虑和抑郁。他们提供了有关 MPN 如何影响其生活的信息。

结果

在 117 名参与者中,31.2%患有 PV、28.4%患有 ET、28.4%患有 MF 和 11.9%患有另一种 MPN。MPN 的时间从不到 1 年(7.5%)、1-3 年(19.8%)、3-5 年(23.6%)、5-10 年(19.8%)和 10 年以上(29.2%)不等。痛苦平均为 3.14(SD,2.83;DT&PL),40.4%符合 NCCN 痛苦标准,平均为 8.97(SD,7.44;HADS),38.5%符合 HADS 痛苦标准。焦虑平均为 5.54(SD,4.37),31.3%符合 HADS 焦虑标准。抑郁平均为 3.4(SD,3.4),12.5%符合 HADS 抑郁标准。PV(3.86)、MF(3.12)和“其他”MPN(4.33)的痛苦高于 ET(1.81;P=.016)。非白人患者(P=.015)和患有 PV 或 MF 但不是 ET 的患者(DT&PL≥4;P=.038)的痛苦更为常见。患者的评论描述了应对策略或症状负担。

结论

BCR-ABL 阴性 MPN 中痛苦和焦虑非常普遍,可能与疾病相关的症状负担相对应。这些发现值得进一步研究。

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