Abstract 4911: Collaboration on quality of life in myeloproliferative neoplasms: Analysis of body mass index and symptom burden
Authors: Christensen Sarah F. , Scherber Robyn M. , Goros Martin , Gelfond Jonathan , Brochmann Nana , Andersen Christen L. , Flachs Esben M. , Hasselbalch Hans C. , Mesa Ruben A. 
Published: August 2019

Abstract
Introduction
BMI increases the risk of Philadelphia-chromosome negative myeloproliferative neoplasms (MPN) development. Patients with MPN often suffer from a severe symptom burden reduced quality of life. The aim of this study was to examine the association between BMI and symptom burden.
Methods
A comprehensive analysis of data from two large cross-sectional surveys of health-related quality of life in MPN patients was done by merging data from the Danish Population-based Study with data from the international Fatigue Study. Both surveys included the validated MPN-SAF questionnaire and questions addressing lifestyle.
Results
Comparing Danish patients with US patients, Danish patients were significantly older (69.2y vs 60.9y, P &lt; 0.001), a smaller proportion were female (56.5%, vs 67.3% P &lt; 0.001) and less patients worked (24.8%, vs 43.3% P &lt; 0.001).
In both the US and the Danish (DK) dataset Normal Weight was most frequent (DK/US=52.4/46.3%), followed by Overweight (DK/US=31.7/30.5%), Obese (DK/US=13.2/21.7%) and least frequent Underweight (DK/US=2.7%/1.5%). Interestingly, we observed a U-shaped association between BMI and Symptom Burden in both datasets with significant higher values of total symptom score for underweight and obese patients relative to normal weight. Furthermore, significant higher scores for Underweight or Obese patients were observed for most individual symptoms (Table 1).
Conclusion
Despite significant differences in demographics, the U-shaped relation between BMI and symptom burden reflects a general pattern of many variables consistent across countries. Weight alteration might be considered as a therapeutic strategy to alter symptom burden in MPN patients, bearing in mind that unintentional weight loss has been demonstrated in some MPN subtypes to be predictive of worsened survival. Further analysis for possible confounders are planned.
Table 1.MPN patients’ assessment of symptom severity by BMI category and CountryDenmark (n=2064)Median [IQR]USA (n=894)Median [IQR]BMIUnder-weight(&lt;18.5)Normal Weight(18.5-24.9)Over-weight(25.0-29.9)Obese(≥ 30)P-valueUnder-weight(&lt;18.5)Normal Weight(18.5-24.9)Over-weight(25.0-29.9)Obese(≥ 30)P-valueFatigue (BFI)3 [0-6]3 [0-5]3 [0-5]3 [1-7]0.0278 [5-9]6 [4-8]7 [5-8]7 [6-9]&lt;0.001Early satiety4 [1-5]2 [0-5]2 [0-5]2 [0-5]0.0013 [0-5]2 [0-5]2 [0-5]3 [0-5]0.494Abdominal pain0 [0-2]0 [0-2]0 [0-2]0 [0-2]0.1681 [0-3]0 [0-2]0 [0-3]1 [0-4]&lt;0.001Abdominal discomfort1 [0-4]0 [0-3]1 [0-3]1 [0-3]0.2963 [1-4]1[0-3]1 [0-4]2 [0-5]0.001Inactivity3 [0-5]1 [0-4]1 [0-4]2 [0-5]0.0034 [1-6]2 [0-5]3 [1-6]5 [3-7]&lt;0.001Headache0 [0-2]0 [0-2]0 [0-3]0 [0-3]0.4012 [0-5]1 [0-4]1 [0-4]2 [0-6]&lt;0.001Concentration problem2 [0-5]1 [0-4]1 [0-4]1 [0-5]0.3110 [0-7]3 [0-6]4 [1-6]5 [2-7]&lt;0.001Dizziness3 [1-5]1 [0-4]1 [0-4]1 [0-4]0.0680 [0-3]1 [0-4]1 [0-5]3 [0-6]0.001Numbness3 [0-5]1 [0-4]1 [0-4]2 [0-5]0.0014 [0-7]1 [0-5]2 [0-5]3 [0-6]0.003Insomnia2 [0-5]2 [0-5]1 [0-5]3 [0-6]0.0035 [3-8]3 [1-6]4 [1-7]5 [2-7]0.004Sad mood2 [0-4]1 [0-3]1 [0-3]1 [0-4]0.5551 [0-5]2 [0-5]3 [0-6]4 [2-6]&lt;0.001Sexuality problems1 [0-5]2 [0-6]3 [0-7]3 [0-8]0.0574 [0-7]3 [0-7]4 [0-7]6 [1-8]0.001Cough2 [0-6]0 [0-3]1 [0-3]1 [0-4]&lt;0.0010 [0-4]0 [0-2]0 [0-3]1[0-5]0.001Night sweats1 [0-4]1 [0-4]2 [0-5]2 [0-5]0.0210 [0-2]1 [0-4]1 [0-5]3 [0-6]&lt;0.001Itching1 [0-3]1 [0-3]1 [0-4]1 [0-4]0.0100 [0-5]1 [0-4]2 [0-5]2 [0-7]&lt;0.001Bone pain1 [0-5]0 [0-3]0 [0-3]1 [0-5]0.0081 [0-4]0 [0-4]0 [0-5]3 [0-6]&lt;0.001Fever0 [0-0]0 [0-0]0 [0-0]0 [0-0]0.2940 [0-0]0 [0-0]0 [0-0]0 [0-0]0.013Weight loss4 [0-7]0 [0-1]0 [0-0]0 [0-0]&lt;0.0012 [0-5]0 [0-1]0 [0-0]0 [0-0]&lt;0.001QoL3 [1-5]2 [1-5]2 [1-5]2 [1-5]0.1154 [3-5]3 [1-5]4 [2-5]4 [3-6]&lt;0.001TSS22 [12-37]16[7-30]16[7-29]21[10-33]0.00126[23-41]22[12-34]26[13-40]32[23-44]&lt;0.001
Citation Format: Sarah F. Christensen, Robyn M. Scherber, Martin Goros, Jonathan Gelfond, Nana Brochmann, Christen L. Andersen, Esben M. Flachs, Hans C. Hasselbalch, Ruben A. Mesa. Collaboration on quality of life in myeloproliferative neoplasms: Analysis of body mass index and symptom burden [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4911.