Modifiable lifestyle factors in patients with myeloproliferative neoplasms in the California teachers study

Abstract Introduction: Myeloproliferative Neoplasms (MPNs) are a rare set of hematologic malignancies associated with thrombotic complications. While interventions such as therapeutic phlebotomy, aspirin, and cytoreductive therapy are helpful thrombotic risk reduction strategies, modification of cardiovascular risk factors is also recommended. We conducted a descriptive analysis on modifiable lifestyle behaviors of patients with MPNs in the California Teachers Study (CTS) cohort. Methods: We conducted a descriptive analysis using data from the CTS, a prospective cohort of over 130,000 adult women who enrolled in 1995 and have been followed continuously, via self-reported surveys and data linkages since. We identified participants diagnosed with MPNs (n=162), including polycythemia vera, essential thrombocytopenia, and primary myelofibrosis. Lifestyle factors were extracted from baseline questionnaires, including smoking status, alcohol intake, physical activity, and dietary patterns. We summarized baseline characteristics and lifestyle distributions of the MPN cohort. Results: The MPN cohort comprised a total of 162 participants, all of which are female with a mean age of 58.2 years old. Mean pack years was 15.4, 51.5% were never smokers, 45.9% were former smokers, and 2.4% were current smokers. Mean BMI was 25.08 with 60.5% were classified as underweight or normal, while 39.4% were classified as overweight or obese. Mean recent alcohol use was 7.1 g/day, with 40.3% of participants with no alcohol use, 51.2% drinking less than 20 g/day (approximately 1.25 drinks/day), and 8.3% drinking more than 20 g/day. Participants had a mean of 3.8 hours of moderate/strenuous exercise per week. Conclusion: The California Teacher Study MPN cohort offers longitudinal insight into the modifiable lifestyle behaviors of female patients afflicted with MPNs in California. More than a third of the cohort is overweight or obese (39.4%), suggesting weight management programs may be particularly important in this population. Alcohol consumption is present in 59.5% of the participants, which may contribute to inflammatory and thrombotic complications in MPN, suggesting that cessation may be an important modifiable risk factor in this cohort. Tobacco use was low with only 2.4% being current smokers. Physical activity shows a low-moderate engagement in exercise. Future studies incorporating survival data and additional modifiable lifestyle factors are needed to better understand the impact of lifestyle factors on survival.