Symptom severity clusters in myeloproliferative neoplasms are unrelated to disease phenotype: results from a multicenter survey of the East German study group for hematology and oncology (OSHO #97)

Background Myeloproliferative neoplasms (MPNs) comprise a heterogeneous group of clonal hematopoietic stem cell disorders with distinct molecular pathogenesis and treatment strategies. Across all MPN subtypes, patients experience a substantial and persistent symptom burden that impairs health-related quality of life (HrQoL). Because MPNs are typically chronic diseases, lifelong symptom management and supportive therapies play a central role in patient care. Supportive care primarily targets disease- and treatment-related symptoms rather than the underlying malignancy itself. However, it remains unclear whether symptom profiles are comparable across MPN subtypes independent of disease phenotype. Therefore, this analysis aimed to identify symptom severity clusters (SSCs) in a cohort of patients with MPN. Methods A multicenter cross-sectional survey was conducted. Patients with MPN aged ≥18 years completed questionnaires assessing sociodemographic and disease-specific variables (e.g., sex, age, diagnosis, and current therapies) as well as the severity of 14 symptoms (e.g., fatigue, musculoskeletal pain, and itching), rated on continuous scales ranging from 0 (absent) to 100 (worst imaginable). Hierarchical and K-means cluster analysis as well as multinomial logistic regression were used to identify SSCs and their associations with patient characteristics. Results The sample comprised 644 patients (63% female; mean age 56.8 ± 13.4 years), including 187 patients with chronic myeloid leukemia, 174 with polycythemia vera, 154 with essential thrombocythemia, and 129 with myelofibrosis. Four SSCs were identified: very high, high, middle, and low symptom severity. Compared with the low SSC, membership in the very high SSC was associated with younger age (95% CI: −0.04 to 0.00) and lower educational level (95% CI: −1.17 to −0.04). Membership in the high SSC was associated with female sex (95% CI: 1.26 to 2.60), higher body mass index (95% CI: 0.00 to 0.11), and lower educational level (95% CI: −1.20 to −0.19). Membership in the very high, high, or middle SSCs, compared with the low SSC, was not associated with diagnostic group. Conclusion Symptom severity in patients with MPN appears to be comparable across disease subtypes. These findings support a shift toward symptom-focused, multimodal supportive care approaches (e.g., exercise and psychological support) in patients with MPN.