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Published in: Health and Quality of Life Outcomes 1/2019

Open Access 01-12-2019 | Primary Myelofibrosis | Research

Development of a symptom assessment in patients with myelofibrosis: qualitative study findings

Authors: Ruben A. Mesa, Yun Su, Adrien Woolfson, Josef T. Prchal, Kathleen Turnbull, Elias Jabbour, Robyn Scherber, Alan L. Shields, Meaghan Krohe, Funke Ojo, Farrah Pompilus, Joseph C. Cappelleri, Claire Harrison

Published in: Health and Quality of Life Outcomes | Issue 1/2019

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Abstract

Background

The goal of the research reported here was to understand the patient experience of living with myelofibrosis (MF) and establish content validity of the Modified Myeloproliferative Neoplasm Symptom Assessment Diary (MPN-SD).

Methods

Qualitative interviews were performed in patients with MF, including both concept elicitation and cognitive debriefing. Patients with MF were asked to spontaneously report on their signs, symptoms, and impacts of MF, as well as their understanding of the MPN-SD content, and use of the tool on an electronic platform. A supplementary literature review and meetings with MF experts were also performed.

Results

Twenty-three patients with MF participated in qualitative interviews. Signs and symptoms most commonly reported by ruxolitinib-experienced patients (n = 16) were: fatigue and/or tiredness (n = 16, 100%), shortness of breath (n = 11, 69%), pain below the ribs on the left side and/or stomach pain and/or abdominal pain (n = 9, 56%), and enlarged spleen (n = 9, 56%) and for ruxolitinib-naïve patients (n = 7) were: fatigue and/or tiredness (n = 6, 86%), pain below the ribs on the left side (n = 6, 86%), enlarged spleen (n = 4, 57%), full quickly/filling up quickly (n = 4, 57%), night sweats and/or general sweats (n = 4, 57%), and itching (n = 4, 57%). Patients demonstrated that they were able to read, understand, and provide meaningful responses to the MPN-SD. The final version of the MPN-SD includes the 10 most commonly reported concepts from the MF patient interviews.

Conclusions

The findings demonstrate the comprehensiveness of the MPN-SD in assessing MF symptoms in both ruxolitinib-experienced and ruxolitinib-naïve patients, while remaining easy for patients to understand and complete.
Literature
1.
go back to reference Mesa RA, Shields A, Hare T, et al. Progressive burden of myelofibrosis in untreated patients: assessment of patient-reported outcomes in patients randomized to placebo in the COMFORT-I study. Leuk Res. 2013;37:911–6.CrossRef Mesa RA, Shields A, Hare T, et al. Progressive burden of myelofibrosis in untreated patients: assessment of patient-reported outcomes in patients randomized to placebo in the COMFORT-I study. Leuk Res. 2013;37:911–6.CrossRef
2.
go back to reference Mesa RA, Niblack J, Wadleigh M, et al. The burden of fatigue and quality of life in myeloproliferative disorders (MPDs): an international internet-based survey of 1179 MPD patients. Cancer. 2007;109:68–76.CrossRef Mesa RA, Niblack J, Wadleigh M, et al. The burden of fatigue and quality of life in myeloproliferative disorders (MPDs): an international internet-based survey of 1179 MPD patients. Cancer. 2007;109:68–76.CrossRef
4.
go back to reference US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, Et al: Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims, 2009. US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, Et al: Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims, 2009.
7.
go back to reference Patrick DL, Burke LB, Gwaltney CJ, et al. Content validity-establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1-eliciting concepts for a new PRO instrument. Value Health. 2011;14:967–77.CrossRef Patrick DL, Burke LB, Gwaltney CJ, et al. Content validity-establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1-eliciting concepts for a new PRO instrument. Value Health. 2011;14:967–77.CrossRef
8.
go back to reference Patrick DL, Burke LB, Gwaltney CJ, et al. Content validity-establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 2-assessing respondent understanding. Value Health. 2011;14:978–88.CrossRef Patrick DL, Burke LB, Gwaltney CJ, et al. Content validity-establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 2-assessing respondent understanding. Value Health. 2011;14:978–88.CrossRef
9.
go back to reference Willis GB. Cognitive interviewing: a tool for improving questionnaire design. Thousand Oaks: Sage Publications; 2005.CrossRef Willis GB. Cognitive interviewing: a tool for improving questionnaire design. Thousand Oaks: Sage Publications; 2005.CrossRef
10.
go back to reference Friese S. ATLAS.Ti 7 user guide and reference. Berlin: ATLAS.ti Scientific Software Development GmbH; 2013. Friese S. ATLAS.Ti 7 user guide and reference. Berlin: ATLAS.ti Scientific Software Development GmbH; 2013.
11.
go back to reference Miles MB, Huberman AM. Qualitative data analysis. London: Sage Publications; 1994. Miles MB, Huberman AM. Qualitative data analysis. London: Sage Publications; 1994.
12.
go back to reference Abelsson J, Andreasson B, Samuelsson J, et al. Patients with polycythemia vera have worst impairment of quality of life among patients with newly diagnosed myeloproliferative neoplasms. Leuk Lymphoma. 2013;54:2226–30.CrossRef Abelsson J, Andreasson B, Samuelsson J, et al. Patients with polycythemia vera have worst impairment of quality of life among patients with newly diagnosed myeloproliferative neoplasms. Leuk Lymphoma. 2013;54:2226–30.CrossRef
13.
go back to reference Atallah E, Verstovsek S. Emerging drugs for myelofibrosis. Expert Opin Emerg Drugs. 2012;17:555–70.CrossRef Atallah E, Verstovsek S. Emerging drugs for myelofibrosis. Expert Opin Emerg Drugs. 2012;17:555–70.CrossRef
14.
go back to reference Barugola G, Cavallini A, Lipari G, et al. The role of splenectomy in myelofibrosis with myeloid metaplasia. Minerva Chir. 2010;65:619–25.PubMed Barugola G, Cavallini A, Lipari G, et al. The role of splenectomy in myelofibrosis with myeloid metaplasia. Minerva Chir. 2010;65:619–25.PubMed
15.
go back to reference Becker H, Engelhardt M, von Bubnoff M, et al. Ruxolitinib. Cancer Res. 2014;201:249–57. Becker H, Engelhardt M, von Bubnoff M, et al. Ruxolitinib. Cancer Res. 2014;201:249–57.
16.
go back to reference Bouabdallah R, Coso D, Gonzague-Casabianca L, et al. Safety and efficacy of splenic irradiation in the treatment of patients with idiopathic myelofibrosis: a report on 15 patients. Leuk Res. 2000;24:491–5.CrossRef Bouabdallah R, Coso D, Gonzague-Casabianca L, et al. Safety and efficacy of splenic irradiation in the treatment of patients with idiopathic myelofibrosis: a report on 15 patients. Leuk Res. 2000;24:491–5.CrossRef
17.
go back to reference Emanuel RM, Dueck AC, Geyer HL, et al. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs. J Clin Oncol. 2012;30:4098–103.CrossRef Emanuel RM, Dueck AC, Geyer HL, et al. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs. J Clin Oncol. 2012;30:4098–103.CrossRef
18.
go back to reference Gimenez E, Besses C, Boque C, et al. Indirect and non-medical economic burden, quality-of-life, and disabilities of the myelofibrosis disease in Spain. J Med Econ. 2014;17:435–41.CrossRef Gimenez E, Besses C, Boque C, et al. Indirect and non-medical economic burden, quality-of-life, and disabilities of the myelofibrosis disease in Spain. J Med Econ. 2014;17:435–41.CrossRef
19.
go back to reference Harrison C, Kiladjian JJ, Al-Ali HK, et al. JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis. N Engl J Med. 2012;366:787–98.CrossRef Harrison C, Kiladjian JJ, Al-Ali HK, et al. JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis. N Engl J Med. 2012;366:787–98.CrossRef
20.
go back to reference Harrison CN, Mesa RA, Kiladjian JJ, et al. Health-related quality of life and symptoms in patients with myelofibrosis treated with ruxolitinib versus best available therapy. Br J Haematol. 2013;162:229–39.CrossRef Harrison CN, Mesa RA, Kiladjian JJ, et al. Health-related quality of life and symptoms in patients with myelofibrosis treated with ruxolitinib versus best available therapy. Br J Haematol. 2013;162:229–39.CrossRef
21.
go back to reference Johansson P, Mesa R, Scherber R, et al. Association between quality of life and clinical parameters in patients with myeloproliferative neoplasms. Leuk Lymphoma. 2012;53:441–4.CrossRef Johansson P, Mesa R, Scherber R, et al. Association between quality of life and clinical parameters in patients with myeloproliferative neoplasms. Leuk Lymphoma. 2012;53:441–4.CrossRef
22.
go back to reference Komrokji R, Verstovsek S. Assessing efficacy in myelofibrosis treatment: a focus on JAK inhibition. Expert Rev Hematol. 2012;5:631–41.CrossRef Komrokji R, Verstovsek S. Assessing efficacy in myelofibrosis treatment: a focus on JAK inhibition. Expert Rev Hematol. 2012;5:631–41.CrossRef
23.
go back to reference Kremyanskaya M, Atallah EL, Hoffman R, et al. Clarifying the use of ruxolitinib in patients with myelofibrosis. Oncology (Williston Park). 2013;27:706–14. Kremyanskaya M, Atallah EL, Hoffman R, et al. Clarifying the use of ruxolitinib in patients with myelofibrosis. Oncology (Williston Park). 2013;27:706–14.
24.
go back to reference Mesa RA, Schwager S, Radia D, et al. The myelofibrosis symptom assessment form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis. Leuk Res. 2009;33:1199–203.CrossRef Mesa RA, Schwager S, Radia D, et al. The myelofibrosis symptom assessment form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis. Leuk Res. 2009;33:1199–203.CrossRef
25.
go back to reference Mesa RA, Kantarjian H, Tefferi A, et al. Evaluating the serial use of the myelofibrosis symptom assessment form for measuring symptomatic improvement: performance in 87 myelofibrosis patients on a JAK1 and JAK2 inhibitor (INCB018424) clinical trial. Cancer. 2011;117:4869–77.CrossRef Mesa RA, Kantarjian H, Tefferi A, et al. Evaluating the serial use of the myelofibrosis symptom assessment form for measuring symptomatic improvement: performance in 87 myelofibrosis patients on a JAK1 and JAK2 inhibitor (INCB018424) clinical trial. Cancer. 2011;117:4869–77.CrossRef
26.
go back to reference Mesa RA, Gotlib J, Gupta V, et al. Effect of ruxolitinib therapy on myelofibrosis-related symptoms and other patient-reported outcomes in COMFORT-I: a randomized, double-blind, placebo-controlled trial. J Clin Oncol. 2013;31:1285–92.CrossRef Mesa RA, Gotlib J, Gupta V, et al. Effect of ruxolitinib therapy on myelofibrosis-related symptoms and other patient-reported outcomes in COMFORT-I: a randomized, double-blind, placebo-controlled trial. J Clin Oncol. 2013;31:1285–92.CrossRef
27.
go back to reference Mesa RA, Kiladjian JJ, Verstovsek S, et al. Comparison of placebo and best available therapy for the treatment of myelofibrosis in the phase 3 COMFORT studies. Haematologica. 2014;99:292–8.CrossRef Mesa RA, Kiladjian JJ, Verstovsek S, et al. Comparison of placebo and best available therapy for the treatment of myelofibrosis in the phase 3 COMFORT studies. Haematologica. 2014;99:292–8.CrossRef
28.
go back to reference Mughal TI, Vaddi K, Sarlis NJ, et al. Myelofibrosis-associated complications: pathogenesis, clinical manifestations, and effects on outcomes. Int J Gen Med. 2014;7:89–101.PubMedPubMedCentral Mughal TI, Vaddi K, Sarlis NJ, et al. Myelofibrosis-associated complications: pathogenesis, clinical manifestations, and effects on outcomes. Int J Gen Med. 2014;7:89–101.PubMedPubMedCentral
29.
go back to reference Ostojic A, Vrhovac R, Verstovsek S. Ruxolitinib: a new JAK1/2 inhibitor that offers promising options for treatment of myelofibrosis. Future Oncol. 2011;7:1035–43.CrossRef Ostojic A, Vrhovac R, Verstovsek S. Ruxolitinib: a new JAK1/2 inhibitor that offers promising options for treatment of myelofibrosis. Future Oncol. 2011;7:1035–43.CrossRef
30.
go back to reference Ostojic A, Vrhovac R, Verstovsek S. Ruxolitinib for the treatment of myelofibrosis: its clinical potential. Ther Clin Risk Manag. 2012;8:95–103.PubMedPubMedCentral Ostojic A, Vrhovac R, Verstovsek S. Ruxolitinib for the treatment of myelofibrosis: its clinical potential. Ther Clin Risk Manag. 2012;8:95–103.PubMedPubMedCentral
31.
go back to reference Padrnos L, Mesa RA. A closer look at pacritinib: a JAK2/FLT3 inhibitor for the treatment of myelofibrosis. Expert Opinion on Orphan Drugs. 2014;2:725–33.CrossRef Padrnos L, Mesa RA. A closer look at pacritinib: a JAK2/FLT3 inhibitor for the treatment of myelofibrosis. Expert Opinion on Orphan Drugs. 2014;2:725–33.CrossRef
32.
go back to reference Quintas-Cardama A, Kantarjian H, Cortes J, et al. Janus kinase inhibitors for the treatment of myeloproliferative neoplasias and beyond. Nat Rev Drug Discov. 2011;10:127–40.CrossRef Quintas-Cardama A, Kantarjian H, Cortes J, et al. Janus kinase inhibitors for the treatment of myeloproliferative neoplasias and beyond. Nat Rev Drug Discov. 2011;10:127–40.CrossRef
33.
go back to reference Santos FP, Verstovsek S. Breakthroughs in myeloproliferative neoplasms. Hematology. 2012;17(Suppl 1):S55–8.CrossRef Santos FP, Verstovsek S. Breakthroughs in myeloproliferative neoplasms. Hematology. 2012;17(Suppl 1):S55–8.CrossRef
34.
go back to reference Scherber R, Dueck AC, Johansson P. The myeloproliferative neoplasm symptom assessment form (MPN-SAF): international prospective validation and reliability trial in 402 patients. Blood. 2011;118:401–8.CrossRef Scherber R, Dueck AC, Johansson P. The myeloproliferative neoplasm symptom assessment form (MPN-SAF): international prospective validation and reliability trial in 402 patients. Blood. 2011;118:401–8.CrossRef
35.
go back to reference Tefferi A, Barosi G, Mesa RA, et al. International working group (IWG) consensus criteria for treatment response in myelofibrosis with myeloid metaplasia, for the IWG for myelofibrosis research and treatment (IWG-MRT). Blood. 2006;108:1497–503.CrossRef Tefferi A, Barosi G, Mesa RA, et al. International working group (IWG) consensus criteria for treatment response in myelofibrosis with myeloid metaplasia, for the IWG for myelofibrosis research and treatment (IWG-MRT). Blood. 2006;108:1497–503.CrossRef
36.
go back to reference Tefferi A, Hudgens S, Mesa R, et al. Use of the functional assessment of Cancer therapy--anemia in persons with myeloproliferative neoplasm-associated myelofibrosis and anemia. Clin Ther. 2014;36:560–6.CrossRef Tefferi A, Hudgens S, Mesa R, et al. Use of the functional assessment of Cancer therapy--anemia in persons with myeloproliferative neoplasm-associated myelofibrosis and anemia. Clin Ther. 2014;36:560–6.CrossRef
37.
go back to reference Thiele J, Kvasnicka HM, Werden C, et al. Idiopathic primary osteo-myelofibrosis: a clinico-pathological study on 208 patients with special emphasis on evolution of disease features, differentiation from essential thrombocythemia and variables of prognostic impact. Leuk Lymphoma. 1996;22:303–17.CrossRef Thiele J, Kvasnicka HM, Werden C, et al. Idiopathic primary osteo-myelofibrosis: a clinico-pathological study on 208 patients with special emphasis on evolution of disease features, differentiation from essential thrombocythemia and variables of prognostic impact. Leuk Lymphoma. 1996;22:303–17.CrossRef
38.
go back to reference Verstovsek S, Kantarjian H, Mesa RA, et al. Safety and efficacy of INCB018424, a JAK1 and JAK2 inhibitor, in myelofibrosis. N Engl J Med. 2010;363:1117–27.CrossRef Verstovsek S, Kantarjian H, Mesa RA, et al. Safety and efficacy of INCB018424, a JAK1 and JAK2 inhibitor, in myelofibrosis. N Engl J Med. 2010;363:1117–27.CrossRef
39.
go back to reference Verstovsek S. Ruxolitinib: an oral Janus kinase 1 and Janus kinase 2 inhibitor in the management of myelofibrosis. Postgrad Med. 2013;125:128–35.CrossRef Verstovsek S. Ruxolitinib: an oral Janus kinase 1 and Janus kinase 2 inhibitor in the management of myelofibrosis. Postgrad Med. 2013;125:128–35.CrossRef
40.
go back to reference Wade R, Rose M, Neilson AR, et al. Ruxolitinib for the treatment of myelofibrosis: a NICE single technology appraisal. Pharmacoeconomics. 2013;31:841–52.CrossRef Wade R, Rose M, Neilson AR, et al. Ruxolitinib for the treatment of myelofibrosis: a NICE single technology appraisal. Pharmacoeconomics. 2013;31:841–52.CrossRef
Metadata
Title
Development of a symptom assessment in patients with myelofibrosis: qualitative study findings
Authors
Ruben A. Mesa
Yun Su
Adrien Woolfson
Josef T. Prchal
Kathleen Turnbull
Elias Jabbour
Robyn Scherber
Alan L. Shields
Meaghan Krohe
Funke Ojo
Farrah Pompilus
Joseph C. Cappelleri
Claire Harrison
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2019
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1121-1

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