Abstract
Elevated body mass index (BMI) is a global health problem, leading to enhanced mortality and the increased risk of several cancers including essential thrombocythemia (ET), a subtype of the Philadelphia-chromosome negative myeloproliferative neoplasms (MPN). Furthermore, evidence states that BMI is associated with the severity of symptom burden among cancer patients. MPN patients often suffer from severe symptom burden. The purpose of this study was to examine whether deviations from a normal BMI in an MPN population are associated with higher symptom burden and reduced quality of life (QoL). A combined analysis of two large cross-sectional surveys, the Danish Population-based Study, MPNhealthSurvey (n = 2044), and the international Fatigue Study (n = 1070), was performed. Symptoms and QoL were assessed using the validated Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF). Analysis of covariance was used to estimate the effects of different BMI categories on symptom scores while adjusting for age, sex, and MPN subtype. A U-shaped association between BMI and Total Symptom Burden was observed in both datasets with significantly higher mean scores for underweight and obese patients relative to normal weight (mean difference: underweight 5.51 (25.8%), p = 0.006; obese 5.70 (26.6%) p < 0.001). This is an important finding, as BMI is a potentially modifiable factor in the care of MPN patients.
Highlights
Body mass index (BMI) is a key global health issue worldwide, as the prevalence of obesity has increased to a pandemic extent, and obesity has become one of the leading risk factors for premature death [1,2]
Patients were of typical age for the disorder with a distribution of participants consisting of 1047 patients with essential thrombocythemia (ET) (33.7%), 1301 patients with polycythemia vera (PV) (41.8%), 330 patients with MF (10.6%), and 433 with myeloproliferative neoplasms (MPN)-U (13.9%)
Our understanding of the multifactorial causes of the different disease-related symptoms are currently sparse, and further research uncovering contributing factors are crucial. This is the first study to investigate if total symptom burden (TSS), individual MPN symptoms, and quality of life are associated with body mass index (BMI)
Summary
Body mass index (BMI) is a key global health issue worldwide, as the prevalence of obesity has increased to a pandemic extent, and obesity has become one of the leading risk factors for premature death [1,2]. Besides ET, Philadelphia-negative myeloproliferative neoplasms (MPN) encompass polycythemia vera (PV), myelofibrosis (MF), and MPN unclassified (MPN-U) They are acquired clonal hematologic cancers characterized by a state of chronic inflammation [16,17]. Through their lifelong course of disease, MPN patients are at risk of developing splenomegaly, vascular complications, bone marrow failure and progressing to acute myeloid leukemia [18], and in their daily lives, the patients often suffer from debilitating symptoms including fatigue, pruritus, abdominal discomfort, night sweats, and early satiety [19]. A broad body of literature evidences that an elevated BMI is associated with increased symptom burden and reduced health-related quality of life (HRQoL) [32,33,34,35,36,37,38,39,40]. The aim of this study is to examine the association between BMI and symptom burden and quality of life, respectively
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