March 28, 2025
John Schieszer
Distress is a critical yet underrecognized factor affecting quality of life, treatment adherence, and healthcare utilization in classical Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs): polycythemia vera (PV), essential thrombocythemia (ET), myelofibrosis (MF), according to results of a retrospective study. The study revealed that despite consensus recommendations, most patients with distress ≥4 were not evaluated by supportive services (SS).
“Our findings underscore the importance of integrating distress screening with actionable follow-ups to ensure that patients receive timely supportive care,” said first study author Rushil V. Patel, MD, an assistant professor of Hematology/Oncology at The University of Alabama at Birmingham. “For hematologists, the key takeaway is that screening alone is insufficient and systematic referral pathways and proactive engagement with supportive services are essential. An interdisciplinary approach could significantly enhance patient-centered care.”
There is an urgent need to address the unmet needs of this population. The National Comprehensive Cancer Network (NCCN) recommends screening patients for distress by a self-reported scale (0-10) and to refer those with scores ≥4 to SS.
Researchers looked at 141 patients (44 PV, 49 ET, and 48 MF). The median age was 63 years (range, 25-89). The researchers retrospectively identified MPN patients at a single center to measure the proportions of patients with distress ≥4 evaluated by an SS (chaplaincy, integrative oncology, palliative medicine, psychiatry, psychology, and social work).
The team also investigated acute care utilization (ACU; ≥1 ED visit or hospitalization) within 6 months of electronic distress screening (EDS). In order to stratify variables associated with distress, the investigators obtained sociodemographic, disease characteristics, and symptom score data. The cohort was predominantly female (62%) and White (77%).
As part of routine care, the NCCN recommends using the MPN-Symptom Assessment Form Total Symptom Score (SAF TSS), which is a validated measure of 10 symptoms clinically relevant to MPNs. Data captured from the EDS included location, time of screening and patient-reported information (gender, race, ethnicity, psychosocial variables). These were linked to the electronic medical record (EMR). Distress was based on a single self-reported question: “How much distress have you been feeling in the past week?”