Essential thrombocythaemia (ET) is a myeloproliferative neoplasm characterized by elevated platelet counts and increased incidence of thrombosis and haemorrhage. Median age at diagnosis is 65-70 years. Life expectancy is similar to that of the healthy population. Symptoms and complications may affect quality of life (QoL); in particular, in elderly patients ET may represent an additional burden. We performed a survey in 494 elderly ET patients to evaluate patient-reported outcomes (PROs). Comorbidities were present in 305 (62%) patients. Factorial analysis based on survey items representing psychological aspects of daily life identified an "attitude domain" with four clusters of patients: (A) very pessimistic (n = 99), (B) pessimistic (n = 101), (C) optimistic (n = 90), and (D) very optimistic (n = 107). Patients in cluster A had more comorbidities (p = 0.003) while patients in cluster D required fewer medical visits and were less disturbed by medications (p < 0.0001). Independent factors predicting Short-Form Health Survey, version 2 physical QoL were grade of optimism (p < 0.0001), gender (p = 0.007), and Charlson comorbidity index (p < 0.0001)). Grade of optimism and disturbances related to medication predicted mental QOL (p < 0.0001). In conclusion, physicians should take into consideration PROs, as "attitude" is associated with physical and mental QoL. Treatment should be tailored to patients' needs according to comorbidities, lifestyle, and psychological conditions.
Quality of life in elderly patients with essential thrombocythaemia. An Italian multicentre study / Esther Natalie, Oliva; Andrea, Piccin; Mazzucconi, Maria Gabriella; Enrica, Morra; Umberto, Recine; Enrico Maria, Pogliani; Fabrizio, Pane; Marco, Gobbi; Luigi, Gugliotta; Mauro, Krampera; Nicola, Cascavilla; Rossella, Cacciola; Emma, Cacciola; Giuseppe, Fioritoni; Renato, Fanin; Anna Marina, Liberati; Emanuele, Angelucci; Sante, Tura. - In: ANNALS OF HEMATOLOGY. - ISSN 0939-5555. - STAMPA. - 91:4(2012), pp. 527-532. [10.1007/s00277-011-1341-x]