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Comprehensively understanding fatigue in patients with myeloproliferative neoplasms
Author(s) -
Scherber Robyn M.,
Kosiorek Heidi E.,
Senyak Zhenya,
Dueck Amylou C.,
Clark Matthew M.,
Boxer Michael A.,
Geyer Holly L.,
McCallister Archie,
Cotter Mary,
Van Husen Barbara,
Harrison Claire N.,
Mesa Ruben A.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29753
Subject(s) - medicine , chronic fatigue syndrome , depression (economics) , fibromyalgia , myeloproliferative neoplasm , physical therapy , diabetes mellitus , medical prescription , body mass index , sick leave , bone marrow , economics , myelofibrosis , macroeconomics , endocrinology , pharmacology
BACKGROUND Patients with myeloproliferative neoplasms (MPNs) experience a high persistence, prevalence, and severity of fatigue. There is currently only limited information regarding factors that contribute to fatigue in patients with MPNs. METHODS A 70‐item, Internet‐based survey regarding fatigue was developed by MPN investigators and patients/advocates and hosted by the Mayo Clinic Survey Research Center. RESULTS Fatigue was found to be prevalent and severe among international survey respondents (1788 respondents). Higher body mass index ( P <.001), current use of alcohol ( P <.001), and current tobacco use ( P = .0025) were found to be significantly associated with greater fatigue. Moderate/severe fatigue was present more frequently in those individuals who did not exercise compared with those who reported exercising at least once per week ( P <.001). Medical comorbidities found to be significantly associated with greater fatigue included restless leg syndrome ( P = .006), diabetes mellitus ( P = .045), fibromyalgia ( P < 0.001), chronic fatigue syndrome ( P = .006), and chronic kidney disease ( P = .02). Current use of antidepressants ( P <.001), antihistamines ( P = .0276), antianxiety medications ( P = .0357), and prescription pain medications ( P <.001) were found to be associated with worsened fatigue. Nearly 25% of respondents scored > 2 on the Patient Health Questionnaire, indicating a high probability of depression. Higher Brief Fatigue Inventory score, Myeloproliferative Neoplasm Total Symptom Score, and individual symptom items were all associated with a higher likelihood of depressive symptoms ( P <.0001). CONCLUSIONS The management of fatigue should be multifactorial, with a comprehensive assessment and treatment plan to address all modifiable fatigue etiologies. Patients with MPNs likely have a higher prevalence of mood disturbances compared with the general population, suggesting the need to assess and intervene in this domain. Cancer 2016;122:477–485. © 2015 American Cancer Society .