Harrison Claire N, Koschmieder Steffen, Foltz Lynda, Guglielmelli Paola, Flindt Tina, Koehler Michael, Mathias Jonathan, Komatsu Norio, Boothroyd Robert N, Spierer Amber, Perez Ronco Julian, Taylor-Stokes Gavin, Waller John, Mesa Ruben A
Guy's and St Thomas' NHS Foundation Trust, Guy's and St Thomas' Hospital, London, SE1 9RT, UK.
Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.
Ann Hematol. 2017 Oct;96(10):1653-1665. doi: 10.1007/s00277-017-3082-y. Epub 2017 Aug 5.
Myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia (ET) are myeloproliferative neoplasms (MPNs) associated with high disease burden, reduced quality of life (QOL), and shortened survival. To assess how MPNs affect patients, we conducted a global MPN Landmark survey. This online survey of patients with MPNs and physicians was conducted in Australia, Canada, Germany, Japan, Italy, and the United Kingdom. The survey measured MPN-related symptoms and the impact of MPNs on QOL and the ability to work as well as disease-management strategies. Overall, 219 physicians and 699 patients (MF, n = 174; PV, n = 223; ET, n = 302) completed the survey; 90% of patients experienced MPN-related symptoms. The most frequent and severe symptom was fatigue. Most patients experienced a reduction in QOL, including those with low symptom burden or low-risk scores. A substantial proportion of patients reported impairment at work and in overall activity. Interestingly, physician feedback and blood counts were the most important indicators of treatment success among patients, with improvements in symptoms and QOL being less important. Regarding disease management, our study revealed a lack of alignment between physician and patient perceptions relating to communication and disease management, with patients often having different treatment goals than physicians. Overall, our study suggested that therapies that reduce symptom burden and improve QOL in patients with MPNs are crucial in minimizing disease impact on patient daily lives. Additionally, our findings showed a need for improved patient-physician communication, standardized monitoring of symptoms, and agreement on treatment goals.
骨髓纤维化(MF)、真性红细胞增多症(PV)和原发性血小板增多症(ET)是骨髓增殖性肿瘤(MPN),与高疾病负担、生活质量(QOL)降低和生存期缩短相关。为评估MPN如何影响患者,我们开展了一项全球性MPN标志性调查。这项针对MPN患者和医生的在线调查在澳大利亚、加拿大、德国、日本、意大利和英国进行。该调查衡量了与MPN相关的症状、MPN对QOL和工作能力的影响以及疾病管理策略。总体而言,219名医生和699名患者(MF,n = 174;PV,n = 223;ET,n = 302)完成了调查;90%的患者出现与MPN相关的症状。最常见且最严重的症状是疲劳。大多数患者的QOL有所下降,包括那些症状负担轻或风险评分低的患者。相当一部分患者报告在工作和总体活动方面存在障碍。有趣的是,医生的反馈和血细胞计数是患者眼中治疗成功的最重要指标,而症状和QOL的改善则没那么重要。关于疾病管理,我们的研究显示医生和患者在沟通和疾病管理方面的认知缺乏一致性,患者的治疗目标往往与医生不同。总体而言,我们的研究表明,减轻MPN患者症状负担并改善其QOL的疗法对于将疾病对患者日常生活的影响降至最低至关重要。此外,我们的研究结果表明需要改善医患沟通、对症状进行标准化监测以及就治疗目标达成共识。