Comprehensively understanding fatigue in patients with myeloproliferative neoplasms

Robyn M. Scherber, Heidi E. Kosiorek, Zhenya Senyak, Amylou C. Dueck, Matthew M. Clark, Michael A. Boxer, Holly L. Geyer, Archie McCallister, Mary Cotter, Barbara Van Husen, Claire N. Harrison, Ruben A. Mesa

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)477-485
Number of pages9
Issue number3
StatePublished - Feb 1 2016


  • essential thrombocythemia
  • fatigue
  • myelofibrosis
  • polycythemia vera
  • quality of life

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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