A group of researchers from several institutions in Denmark recently sought to understand the effects of different cytoreductive therapies for myeloproliferative neoplasms (MPN) on quality of life by self-reported MPN Symptom Assessment Form (MPN-SAF) score.
Therapies investigated were hydroxyurea (HU) and pegylated interferon-alpha2a/b (INFα-2a/2b). Newly diagnosed patients were randomized to treatment by age >60 years (HU, INFα-2a, INFα-2b) or age ≤60 years (INFα-2a or INFα-2b).
MPN-SAF scores were recorded at baseline and at 4, 8, 12, 18, 24, 30, and 36 months. Scores were compared in 2 sets: HU >60 years versus INFα >60 years and INFα-2a versus INFα-2b. These comparisons avoided age bias.
At 36 months, only 96 of an initial 199 patients who completed the MPN-SAF at baseline had completed an MPN-SAF. The overall discontinuation of therapy rate at 36 months was 48%. A total of 179 patients completed at least 1 MPN-SAF during the follow-up period.
Total symptom burden (reported as total symptom score [TSS]) increased in all treatment groups from baseline to 4 months. No significant differences existed in TSS between any of the comparison groups. The only group to experience statistically significant increase in TSS was the HU >60 group, and only at 36-month follow-up.
During the study period, patients receiving HU reported increases in symptoms of fatigue, abdominal pain or discomfort, sexuality problems, itching, and bone pain. Patients who received INFα reported increases in symptoms of fatigue, early satiety, abdominal pain, abdominal discomfort, inactivity, headache, concentration problems, numbness, dizziness, insomnia, sexuality problems, cough, and itching.
At the end of the study period, fatigue was the most-reported symptom, and 63% of patients who completed the 36-month MPN-SAF reported 1 or more moderate or severe symptoms.
Some patients who had symptoms at baseline did report a reduction in symptoms during the study period (HU >60: 23% vs IFNα >60: 30%; IFNα-2a: 33% vs IFNα-2b: 38%), though the reduction was not statistically significant.
Knudsen TA, Hansen DL, Ocias LF, et al. Quality of life and symptom burden of patients with MPN during treatment with hydroxyurea or pegylated interferon-alpha2: results from a randomized controlled trial. Abstract #743. Presented at the 64th ASH Annual Meeting and Exposition; December 10-13, 2022; New Orleans, Louisiana.
