title: The role of sexuality symptoms in myeloproliferative neoplasm symptom burden and quality of life: An analysis by the MPN QOL International Study Group.
abstract: BACKGROUND
  Patients with myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia, and myelofibrosis, are faced with oppressive symptom profiles that compromise daily functioning and quality of life. Among these symptoms, sexuality-related symptoms have emerged as particularly prominent and largely unaddressed. In the current study, the authors evaluated how sexuality symptoms from MPN relate to other patient characteristics, disease features, treatments, and symptoms.
  
  
  METHODS
  A total of 1971 patients with MPN (827 with essential thrombocythemia, 682 with polycythemia vera, 456 with myelofibrosis, and 6 classified as other) were prospectively evaluated and patient responses to the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ C30) were collected, along with information regarding individual disease characteristics and laboratory data. Sexuality scores were compared with an age-matched, healthy control population.
  
  
  RESULTS
  Overall, patients with MPN were found to have greater sexual dysfunction compared with the healthy population (MPN-SAF score of 3.6 vs 2.0; P<.001), with 64% of patients with MPN describing some degree of sexual dysfunction and 43% experiencing severe symptoms. The presence of sexual symptoms correlated closely with all domains of patient functionality (physical, social, cognitive, emotional, and role functioning) and were associated with a reduced quality of life. Sexual problems also were found to be associated with other MPN symptoms, particularly depression and nocturnal and microvascular-related symptoms. Sexual dysfunction was more severe in patients aged >65 years and in those with cytopenias and transfusion requirements, and those receiving certain therapies such as immunomodulators or steroids.
  
  
  CONCLUSIONS
  The results of the current study identify the topic of sexuality as a prominent issue for the MPN population, and this area would appear to benefit from additional investigation and management. Cancer 2016;122:1888-96. © 2016 American Cancer Society.
authors.affiliation: Division of Hospital Internal Medicine, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Holly L
authors.initials: HL
authors.lastname: Geyer
authors.affiliation: Internal Medicine, NU Hospital Organization, Uddevalla, Sweden.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Andreasson
authors.affiliation: Section of Biostatistics, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Kosiorek
authors.affiliation: Section of Biostatistics, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Amylou C
authors.initials: AC
authors.lastname: Dueck
authors.affiliation: Department of Hematology and Oncology, Oregon Health and Science University, Portland, Oregon.
authors.forename: Robyn M
authors.initials: RM
authors.lastname: Scherber
authors.affiliation: Department of Psychiatry, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Kari A
authors.initials: KA
authors.lastname: Martin
authors.affiliation: Department of Gynecology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Kristina A
authors.initials: KA
authors.lastname: Butler
authors.affiliation: Department of Haematology, Guy's and St. Thomas NHS Foundation Trust, London, United Kingdom.
authors.forename: Claire N
authors.initials: CN
authors.lastname: Harrison
authors.affiliation: Department of Haematology, Guy's and St. Thomas NHS Foundation Trust, London, United Kingdom.
authors.forename: Deepti H
authors.initials: DH
authors.lastname: Radia
authors.affiliation: Hematology Department, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Cervantes
authors.affiliation: Clinical Investigation Center, Hospital Saint-Louis, Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Kiladjian
authors.affiliation: Medical Clinic, University of Mannheim, Mannheim, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Reiter
authors.affiliation: Department of Hematology, University Hospital, Uppsala, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Birgegard
authors.affiliation: Department of Hematology, IRCCS Foundation San Matteo Polyclinic, University of Pavia, Pavia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Passamonti
authors.affiliation: MPN Forum, Asheville, North Carolina.
authors.forename: Zhenya
authors.initials: Z
authors.lastname: Senyak
authors.affiliation: Division of Hematology, Circolo Hospital, Varese, Italy.
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Vannucchi
authors.affiliation: Department of Medicine, University of Florence, Florence, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Paoli
authors.affiliation: MDS and MPN Centre, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Department of Internal Medicine, Stockholm South Hospital, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Samuelsson
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Ruben A
authors.initials: RA
authors.lastname: Mesa
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000503:physiopathology* / Q000523:psychology*; D011087:Polycythemia Vera / Q000503:physiopathology / Q000523:psychology; D055728:Primary Myelofibrosis / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D019529:Sexuality; D011795:Surveys and Questionnaires; D013920:Thrombocythemia, Essential / Q000503:physiopathology / Q000523:psychology
keywords: hematological neoplasms; myeloproliferative neoplasms; quality of life; sexuality; symptoms