Contributions
Abstract: S505
Type: Oral Presentation
Presentation during EHA22: On Saturday, June 24, 2017 from 17:00 - 17:15
Location: Room N109
Background
Pharmacologic therapy stabilizes hematologic counts and splenomegaly in myeloproliferative neoplasms (MPN), however only partial symptom improvement typically occurs. Evidenced-based integrative care may address this need, however data is limited in patients with MPNs.
Aims
To investigate integrative therapy utilization association with symptom burden, quality of life, depression, and fatigue in MPN patients.
Methods
Patients were recruited via social media. Informed consent and online self-report surveys (Qualtrics) were completed capturing patient demographics, disease specific data, supportive care utilization, MPN symptom burden via MPN-SAF TSS, depression via Patient Health Questionnaire (PHQ)-9, fatigue via Brief Fatigue Inventory (BFI) Usual, and an overall quality of life (QOL) single question assessment. ANOVA, chi square tests, and Wilcoxon rank sum tests methods were applied.
Results
Patients: A total of 1087 patient surveys were consented. Of these, 858 had 10 or more responses. There were 338 essential thrombocytosis (ET), 188 myelofibrosis (MF), 315 polycythemia vera (PV), and 17 other. In MF: DIPSS risk categories included low (8%), Int-1 (19%), Int-2 (29%), high (12%), and unknown (32%).Symptom association: Overall, patients had lower MPN related symptoms when participating in aerobic activity (p<0.001), massage (p=<0.001), yoga (p=0.02), strength training (p<0.001), breathing exercises (p=<0.001), and support groups (0.001). Overall quality of life was higher with aerobic activity (p=<0.001), massage (p=0.02), yoga (p=0.02), strength training (p=<0.001), breathing exercises (p=0.01), and support groups (p=0.001). Depression (PHQ-9 total >3 category) was lower in aerobic activity group (p=0.001), yoga (p=0.001), strength training (p=0.001), and meditation (p=0.2). Fatigue was lower in aerobic activity (p=<0.001), massage (p=0.04), strength training (p=<0.001), breathing exercises (p=<0.001), and support groups (p=0.001). In subgroup analysis, ET and PV patients had lower symptom burden (MPN-SAF TSS) with aerobic activity (p=<0.001, <0.001), massage (p= 0.01, 0.02), and strength training (p=0.03,0.02). Support groups were found to be associated with lower symptoms in ET patients (p=0.03). In MF, breathing exercises (p=<0.001) and support groups (p=0.03) were associated with lower symptom burden. See Table #1.
Overall N = 858 | ET N=338 | PV N=315 | MF N=188 | ||||
MPN-SAF TSS | QOL | PHQ-2 | BFI- USUAL | MPN-SAF TSS | MPN-SAF TSS | MPN-SAF TSS | |
Aerobic Activity (Overall) N=442 | <0.001 | <0.001 | 0.001 | <0.001 | <0.001 | <0.001 | 0.06 |
Massage N=244 | <0.001 | 0.02 | 0.94 | 0.04 | 0.01 | 0.02 | 0.14 |
Yoga N=220 | 0.02 | 0.02 | 0.001 | 0.07 | 0.35 | 0.14 | 0.34 |
Nutrition N=216 | 0.10 | 0.18 | 0.25 | 0.48 | 0.36 | 0.07 | 0.68 |
Strength training N=204 | <0.001 | <0.001 | 0.001 | <0.001 | 0.03 | 0.02 | 0.14 |
Acupuncture N=166 | 0.18 | 0.08 | 0.18 | 0.63 | 0.20 | 0.90 | 0.14 |
Meditation N=163 | 0.16 | 0.45 | 0.02 | 0.16 | 0.16 | 0.99 | 0.25 |
Breathing exercise N=158 | <0.001 | 0.01 | 0.12 | <0.001 | 0.37 | 0.30 | <0.001 |
Chiropractic N=139 | 0.87 | 0.81 | 0.15 | 0.60 | 0.39 | 0.55 | 0.94 |
Support groups N=124 | 0.001 | 0.001 | 0.15 | 0.001 | 0.03 | 0.08 | 0.03 |
Conclusion
Integrative therapies are associated with improved symptom burden, quality of life, depression, and fatigue in MPN patients. Interestingly, unique patterns were associated within MPN subtypes. Further studies are needed to understand the benefits of integrative therapies in MPN patients.
Session topic: 35. Quality of life, palliative care, ethics and health economics
Keyword(s): Supportive care, Quality of Life, Myeloproliferative disorder
Abstract: S505
Type: Oral Presentation
Presentation during EHA22: On Saturday, June 24, 2017 from 17:00 - 17:15
Location: Room N109
Background
Pharmacologic therapy stabilizes hematologic counts and splenomegaly in myeloproliferative neoplasms (MPN), however only partial symptom improvement typically occurs. Evidenced-based integrative care may address this need, however data is limited in patients with MPNs.
Aims
To investigate integrative therapy utilization association with symptom burden, quality of life, depression, and fatigue in MPN patients.
Methods
Patients were recruited via social media. Informed consent and online self-report surveys (Qualtrics) were completed capturing patient demographics, disease specific data, supportive care utilization, MPN symptom burden via MPN-SAF TSS, depression via Patient Health Questionnaire (PHQ)-9, fatigue via Brief Fatigue Inventory (BFI) Usual, and an overall quality of life (QOL) single question assessment. ANOVA, chi square tests, and Wilcoxon rank sum tests methods were applied.
Results
Patients: A total of 1087 patient surveys were consented. Of these, 858 had 10 or more responses. There were 338 essential thrombocytosis (ET), 188 myelofibrosis (MF), 315 polycythemia vera (PV), and 17 other. In MF: DIPSS risk categories included low (8%), Int-1 (19%), Int-2 (29%), high (12%), and unknown (32%).Symptom association: Overall, patients had lower MPN related symptoms when participating in aerobic activity (p<0.001), massage (p=<0.001), yoga (p=0.02), strength training (p<0.001), breathing exercises (p=<0.001), and support groups (0.001). Overall quality of life was higher with aerobic activity (p=<0.001), massage (p=0.02), yoga (p=0.02), strength training (p=<0.001), breathing exercises (p=0.01), and support groups (p=0.001). Depression (PHQ-9 total >3 category) was lower in aerobic activity group (p=0.001), yoga (p=0.001), strength training (p=0.001), and meditation (p=0.2). Fatigue was lower in aerobic activity (p=<0.001), massage (p=0.04), strength training (p=<0.001), breathing exercises (p=<0.001), and support groups (p=0.001). In subgroup analysis, ET and PV patients had lower symptom burden (MPN-SAF TSS) with aerobic activity (p=<0.001, <0.001), massage (p= 0.01, 0.02), and strength training (p=0.03,0.02). Support groups were found to be associated with lower symptoms in ET patients (p=0.03). In MF, breathing exercises (p=<0.001) and support groups (p=0.03) were associated with lower symptom burden. See Table #1.
Overall N = 858 | ET N=338 | PV N=315 | MF N=188 | ||||
MPN-SAF TSS | QOL | PHQ-2 | BFI- USUAL | MPN-SAF TSS | MPN-SAF TSS | MPN-SAF TSS | |
Aerobic Activity (Overall) N=442 | <0.001 | <0.001 | 0.001 | <0.001 | <0.001 | <0.001 | 0.06 |
Massage N=244 | <0.001 | 0.02 | 0.94 | 0.04 | 0.01 | 0.02 | 0.14 |
Yoga N=220 | 0.02 | 0.02 | 0.001 | 0.07 | 0.35 | 0.14 | 0.34 |
Nutrition N=216 | 0.10 | 0.18 | 0.25 | 0.48 | 0.36 | 0.07 | 0.68 |
Strength training N=204 | <0.001 | <0.001 | 0.001 | <0.001 | 0.03 | 0.02 | 0.14 |
Acupuncture N=166 | 0.18 | 0.08 | 0.18 | 0.63 | 0.20 | 0.90 | 0.14 |
Meditation N=163 | 0.16 | 0.45 | 0.02 | 0.16 | 0.16 | 0.99 | 0.25 |
Breathing exercise N=158 | <0.001 | 0.01 | 0.12 | <0.001 | 0.37 | 0.30 | <0.001 |
Chiropractic N=139 | 0.87 | 0.81 | 0.15 | 0.60 | 0.39 | 0.55 | 0.94 |
Support groups N=124 | 0.001 | 0.001 | 0.15 | 0.001 | 0.03 | 0.08 | 0.03 |
Conclusion
Integrative therapies are associated with improved symptom burden, quality of life, depression, and fatigue in MPN patients. Interestingly, unique patterns were associated within MPN subtypes. Further studies are needed to understand the benefits of integrative therapies in MPN patients.
Session topic: 35. Quality of life, palliative care, ethics and health economics
Keyword(s): Supportive care, Quality of Life, Myeloproliferative disorder