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Original research article
Submitted: 2022-08-29
Accepted: 2022-11-01
Published online: 2022-11-14
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Comparison of depressive, anxiety, and somatic symptoms in patients with essential thrombocythemia, polycythemia vera, and myelofibrosis treated with interferon alpha

Katarzyna Gibek1, Tomasz Sacha2, Katarzyna Cyranka34
DOI: 10.5603/AHP.a2022.0058
Affiliations
  1. Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
  2. Chair and Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
  4. Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland

open access

Ahead of print
ORIGINAL RESEARCH ARTICLE
Submitted: 2022-08-29
Accepted: 2022-11-01
Published online: 2022-11-14

Abstract

Introduction: The study aims to analyze the occurrence of depression, anxiety, and somatic symptoms in patients with chronic myeloproliferative neoplasms (essential thrombocythemia, polycythemia vera, and myelofibrosis) and to check whether individual side effects of interferon alpha treatment may contribute to the occurrence of depression, anxiety, and somatic symptoms. In addition, it was decided to check whether there were any relationships between age, gender, duration of treatment, and the intensity of anxiety, divided by the occurrence of individual side effects.

Material and methods: The study involved 84 patients and was conducted at the Hematology Clinic of the University Hospital in Krakow and the Clinic of Hematology, Blood Cancer and Bone Marrow Transplantation in Wrocław. The following questionnaires were used: created by the author, David Goldberg General Health Questionnaire 28 (GHQ-28), and the Four-Dimensional Questionnaire (4DSQ).

Results: The most frequently reported side effects of treatment were abdominal pain, fatigue, and bone and joint pain. Almost 40% of the respondents obtained a moderately and strongly increased result on the depression scale, less than 50% on the anxiety scale, and over 60% on the somatization scale. Somatic symptoms had the greatest impact on the occurrence of mental disorders, with anxiety symptoms being second in significance. There are differences in the severity of depressive, anxiety, and somatic symptoms depending on the side effects of interferon alpha treatment.

Conclusions: The finding of the above study indicates the need for further research into the importance of detecting depressive, anxiety, and somatic disorders, and to addressing concomitant physical symptoms, both in patients with myeloproliferative neoplasms receiving interferon alpha and treated with other methods. In patients treated chronically, the occurrence of side effects of high intensity and lasting for a long time should alert medical personnel. The collected data on patients with myeloproliferative neoplasms who have to suffered from mental and physical symptoms of the disease or its treatment justifies the need for caring psychological, psychiatric, and educational care.

Abstract

Introduction: The study aims to analyze the occurrence of depression, anxiety, and somatic symptoms in patients with chronic myeloproliferative neoplasms (essential thrombocythemia, polycythemia vera, and myelofibrosis) and to check whether individual side effects of interferon alpha treatment may contribute to the occurrence of depression, anxiety, and somatic symptoms. In addition, it was decided to check whether there were any relationships between age, gender, duration of treatment, and the intensity of anxiety, divided by the occurrence of individual side effects.

Material and methods: The study involved 84 patients and was conducted at the Hematology Clinic of the University Hospital in Krakow and the Clinic of Hematology, Blood Cancer and Bone Marrow Transplantation in Wrocław. The following questionnaires were used: created by the author, David Goldberg General Health Questionnaire 28 (GHQ-28), and the Four-Dimensional Questionnaire (4DSQ).

Results: The most frequently reported side effects of treatment were abdominal pain, fatigue, and bone and joint pain. Almost 40% of the respondents obtained a moderately and strongly increased result on the depression scale, less than 50% on the anxiety scale, and over 60% on the somatization scale. Somatic symptoms had the greatest impact on the occurrence of mental disorders, with anxiety symptoms being second in significance. There are differences in the severity of depressive, anxiety, and somatic symptoms depending on the side effects of interferon alpha treatment.

Conclusions: The finding of the above study indicates the need for further research into the importance of detecting depressive, anxiety, and somatic disorders, and to addressing concomitant physical symptoms, both in patients with myeloproliferative neoplasms receiving interferon alpha and treated with other methods. In patients treated chronically, the occurrence of side effects of high intensity and lasting for a long time should alert medical personnel. The collected data on patients with myeloproliferative neoplasms who have to suffered from mental and physical symptoms of the disease or its treatment justifies the need for caring psychological, psychiatric, and educational care.

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Keywords

depresson, anxiety, somatization, myeloproliferative neoplasms, essential thrombocythemia, polycythemia vera, myelofibrosis, interferon alpha

About this article
Title

Comparison of depressive, anxiety, and somatic symptoms in patients with essential thrombocythemia, polycythemia vera, and myelofibrosis treated with interferon alpha

Journal

Acta Haematologica Polonica

Issue

Ahead of print

Article type

Original research article

Published online

2022-11-14

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85

Article views/downloads

71

DOI

10.5603/AHP.a2022.0058

Keywords

depresson
anxiety
somatization
myeloproliferative neoplasms
essential thrombocythemia
polycythemia vera
myelofibrosis
interferon alpha

Authors

Katarzyna Gibek
Tomasz Sacha
Katarzyna Cyranka

References (71)
  1. Tefferi A, Thiele J, Vardiman JW. The 2008 World Health Organization classification system for myeloproliferative neoplasms: order out of chaos. Cancer. 2009; 115(17): 3842–3847.
  2. Kralovics R, Passamonti F, Buser AS, et al. A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med. 2005; 352(17): 1779–1790.
  3. Pikman Y, Lee BH, Mercher T, et al. MPLW515L is a novel somatic activating mutation in myelofibrosis with myeloid metaplasia. PLoS Med. 2006; 3(7): e270.
  4. Schnittger S, Bacher U, Haferlach C, et al. Characterization of 35 new cases with four different MPLW515 mutations and essential thrombocytosis or primary myelofibrosis. Haematologica. 2009; 94(1): 141–144.
  5. Nangalia J, Massie CE, Baxter EJ, et al. Somatic CALR mutations in myeloproliferative neoplasms with nonmutated JAK2. N Engl J Med. 2013; 369(25): 2391–2405.
  6. Budziszewska BK, Więckowska B, Lech-Marańda E, et al. Zachorowalność i chorobowość na nowotwory układu krwiotwórczego w Polsce (2009–2015) określone na podstawie analizy danych Narodowego Funduszu Zdrowia wykorzystanych w projekcie „Mapy potrzeb zdrowotnych — baza analiz systemowych i wdrożeniowych”. Hematologia. 2017; 8(2): 89–104.
  7. Góra-Tybor J. Czerwienica prawdziwa i nadpłytkowość samoistna — diagnostyka i terapia. Hematologia. 2014; 5(2): 105–114.
  8. Góra-Tybor J. 1.5. Pierwotna mielofibroza. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych 2019 rok. Onkol Prakt Klin Edu. 2020; 6(Suppl A): 66–76.
  9. Góra-Tybor J. 1.6. Nadłytkowość samoistna. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych 2019 rok. Onkol Klin Prakt Edu. 2020; 6(Suppl A): 78–85.
  10. Góra-Tybor J. 1.4. Czerwienica rawdziwa. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych 2019 rok. Onkol Klin Prakt Edu. 2020; 6(Suppl): 55–65.
  11. Hasselbalch HC. A new era for IFN-α in the treatment of Philadelphia-negative chronic myeloproliferative neoplasms. Expert Rev Hematol. 2011; 4(6): 637–655.
  12. Kiladjian JJ, Guglielmelli P, Griesshammer M, et al. Efficacy and safety of ruxolitinib after and versus interferon use in the RESPONSE studies. Ann Hematol. 2018; 97(4): 617–627.
  13. Verger E, Cassinat B, Chauveau A, et al. Clinical and molecular response to interferon-α therapy in essential thrombocythemia patients with CALR mutations. Blood. 2015; 126(24): 2585–2591.
  14. Forsyth CJ, Chan WH, Grigg AP, et al. Recommendations for the use of pegylated interferon-α in the treatment of classical myeloproliferative neoplasms. Intern Med J. 2019; 49(8): 948–954.
  15. Mascarenhas J, Kosiorek H, Prchal J, et al. A prospective evaluation of pegylated interferon alfa-2a therapy in patients with polycythemia vera and essential thrombocythemia with a prior splanchnic vein thrombosis. Leukemia. 2019; 33(12): 2974–2978.
  16. Huang CE, Wu YY, Hsu CC, et al. Real-world experience with ropeginterferon-alpha 2b (Besremi) in Philadelphia-negative myeloproliferative neoplasms. J Formos Med Assoc. 2021; 120(2): 863–873.
  17. Gisslinger H, Ludwig H, Linkesch W, et al. Long-term interferon therapy for thrombocytosis in myeloproliferative diseases. Lancet. 1989; 1(8639): 634–637.
  18. Pestka S, Krause CD, Walter MR. Interferons, interferon-like cytokines, and their receptors. Immunol Rev. 2004; 202: 8–32.
  19. Kiladjian JJ, Chomienne C, Fenaux P. Interferon-alpha therapy in bcr-abl-negative myeloproliferative neoplasms. Leukemia. 2008; 22(11): 1990–1998.
  20. Kiladjian JJ, Mesa RA, Hoffman R. The renaissance of interferon therapy for the treatment of myeloid malignancies. Blood. 2011; 117(18): 4706–4715.
  21. Yoon SY, Won JH. The clinical role of interferon alpha in Philadelphia-negative myeloproliferative neoplasms. Blood Res. 2021; 56(S1): S44–S50.
  22. Quesada JR, Talpaz M, Rios A, et al. Clinical toxicity of interferons in cancer patients: a review. J Clin Oncol. 1986; 4(2): 234–243.
  23. Kirkwood JM, Bender C, Agarwala S, et al. Mechanisms and management of toxicities associated with high-dose interferon alfa-2b therapy. J Clin Oncol. 2002; 20(17): 3703–3718.
  24. Sleijfer S, Bannink M, Van Gool AR. Side effects of interferon-alpha therapy. Pharm World Sci. 2005; 27: 423–431.
  25. Daud A, Soon C, Dummer R, et al. Management of pegylated interferon alpha toxicity in adjuvant therapy of melanoma. Expert Opin Biol Ther. 2012; 12(8): 1087–1099.
  26. Mondello P, Di Mirto C, Cuzzocrea S, et al. Interferon alpha has a strong anti-tumor effect in Philadelphia-negative myeloproliferative neoplasms. Clin Lymphoma Myeloma Leuk. 2019; 19(8): e489–e495.
  27. Yacoub A, Mascarenhas J, Kosiorek H, et al. Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea. Blood. 2019; 134(18): 1498–1509.
  28. Fitzgerald P, Lo C, Li M, et al. The relationship between depression and physical symptom burden in advanced cancer. BMJ Support Palliat Care. 2015; 5(4): 381–388.
  29. Cella D, Nowinski CJ, Frankfurt O. The impact of symptom burden on patient quality of life in chronic myeloid leukemia. Oncology. 2014; 87(3): 133–147.
  30. Brochmann N, Flachs EM, Christensen AI, et al. Anxiety and depression in patients with Philadelphia-negative myeloproliferative neoplasms: a nationwide population-based survey in Denmark. Clin Epidemiol. 2019; 11: 23–33.
  31. Harrison CN, Koschmieder S, Foltz L, et al. The impact of myeloproliferative neoplasms (MPNs) on patient quality of life and productivity: results from the international MPN Landmark survey. Ann Hematol. 2017; 96(10): 1653–1665.
  32. McFarland DC, Shaffer KM, Polizzi H, et al. Associations of physical and psychologic symptom burden in patients with Philadelphia chromosome-negative myeloproliferative neoplasms. Psychosomatics. 2018; 59(5): 472–480.
  33. McFarland DC, Polizzi H, Mascarenhas J, et al. Psychological symptoms among patients With BCR-ABL-negative myeloproliferative neoplasms. J Natl Compr Canc Netw. 2016; 14(12): 1563–1570.
  34. Padrnos L, Scherber R, Geyer H, et al. Depressive symptoms and myeloproliferative neoplasms: understanding the confounding factor in a complex condition. Cancer Med. 2020; 9(22): 8301–8309.
  35. Kim SaR, Charos A, Damsky W, et al. Treatment of generalized deep morphea and eosinophilic fasciitis with the Janus kinase inhibitor tofacitinib. JAAD Case Rep. 2018; 4(5): 443–445.
  36. Pai SG, Kaplan JB, Giles FJ. Long-acting interferon for myeloproliferative neoplasms — an update. Expert Rev Hematol. 2016; 9(10): 915–917.
  37. Quintás-Cardama A, Kantarjian H, Manshouri T, et al. Pegylated interferon alfa-2a yields high rates of hematologic and molecular response in patients with advanced essential thrombocythemia and polycythemia vera. J Clin Oncol. 2009; 27(32): 5418–5424.
  38. Raison CL, Demetrashvili M, Capuron L, et al. Neuropsychiatric adverse effects of interferon-α. CNS Drugs. 2005; 19(2): 105–123.
  39. Makowska Z, Merecz D. Polska adaptacja kwestionariuszy ogólnego stanu zdrowia Davida Goldberga: GHQ-12 i GHQ-28. Oficyna Wydawnicza IMP, Łódź 2001.
  40. How J, Hobbs G. Use of interferon alfa in the treatment of myeloproliferative neoplasms: perspectives and review of the literature. Cancers (Basel). 2020; 12(7).
  41. Gill H, Leung GMK, Yim R, et al. Myeloproliferative neoplasms treated with hydroxyurea, pegylated interferon alpha-2A or ruxolitinib: clinicohematologic responses, quality-of-life changes and safety in the real-world setting. Hematology. 2020; 25(1): 247–257.
  42. Zarour HM, Tawbi H, Tarhini AA, et al. Study of anti-PD-1 antibody pembrolizumab and pegylated-interferon alfa-2b (Peg-IFN) for advanced melanoma. J Clin Oncol. 2015; 33(15_Suppl): e20018–e20018.
  43. Kruit WH, Goey SH, Monson JR, et al. Clinical experience with the combined use of recombinant interleukin-2 (IL2) and interferon alfa-2a (IFN alpha) in metastatic melanoma. Br J Haematol. 1991; 79(Suppl 1): 84–86.
  44. Veluru C, Atluri D, Chadalavada R, et al. Skin rash during chronic hepatitis C therapy. Gastroenterol Hepatol (N Y). 2010; 6(5): 323–325.
  45. Dragomiretskaya N, Izha A, Kalinichenko N, et al. Use of antiviral therapy in patients with chronic hepatitis C. Open Med (Wars). 2015; 10(1): 209–215.
  46. Kjær L, Cordua S, Holmström MO, et al. Differential dynamics of CALR mutant allele burden in myeloproliferative neoplasms during interferon alfa treatment. PLoS One. 2016; 11(10): e0165336.
  47. Linden W, Vodermaier A, Mackenzie R, et al. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord. 2012; 141(2-3): 343–351.
  48. Scherber RM, Kosiorek HE, Senyak Z, et al. Comprehensively understanding fatigue in patients with myeloproliferative neoplasms. Cancer. 2016; 122(3): 477–485.
  49. Katon W, Lin EHB, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. Gen Hosp Psychiatry. 2007; 29(2): 147–155.
  50. Akechi T, Nakano T, Akizuki N, et al. Somatic symptoms for diagnosing major depression in cancer patients. Psychosomatics. 2003; 44(3): 244–248.
  51. Mesa RA, Scherber RM, Geyer HL. Reducing symptom burden in patients with myeloproliferative neoplasms in the era of Janus kinase inhibitors. Leuk Lymphoma. 2015; 56(7): 1989–1999.
  52. Mazza GL, Mead-Harvey C, Mascarenhas J, et al. Myeloproliferative Neoplasms Research Consortium (MPN-RC) 111 and 112 trial teams. Symptom burden and quality of life in patients with high-risk essential thrombocythaemia and polycythaemia vera receiving hydroxyurea or pegylated interferon alfa-2a: a post-hoc analysis of the MPN-RC 111 and 112 trials. Lancet Haematol. 2022; 9(1): e38–e48.
  53. Berlim MT, Fleck MPA. Quality of life and major depression. In: Ritsner MS, Awad AG. ed. Quality of life impairment in schizophrenia, mood and anxiety disorders. Springer 2007: 241–252.
  54. Ben-Zur H, Gilbar O, Lev S. Coping with breast cancer: patient, spouse, and dyad models. Psychosom Med. 2001; 63(1): 32–39.
  55. Kim HS. [The comparison of the stress and coping methods of cancer patients and their caregivers]. Taehan Kanho Hakhoe Chi. 2003; 33(5): 538–543.
  56. Nissim R, Zimmermann C, Minden M, et al. Abducted by the illness: a qualitative study of traumatic stress in individuals with acute leukemia. Leuk Res. 2013; 37(5): 496–502.
  57. Jagannathan A, Juvva S. Life after cancer in India: coping with side effects and cancer pain. J Psychosoc Oncol. 2009; 27(3): 344–360.
  58. Jagannathan A, Juvva S. Emotions and coping of patients with head and neck cancers after diagnosis: a qualitative content analysis. J Postgrad Med. 2016; 62(3): 143–149.
  59. White NE, Richter JM, Fry C. Coping, social support, and adaptation to chronic illness. West J Nurs Res. 1992; 14(2): 211–224.
  60. Trask PC, Paterson AG, Esper P, et al. Longitudinal course of depression, fatigue, and quality of life in patients with high risk melanoma receiving adjuvant interferon. Psychooncology. 2004; 13(8): 526–536.
  61. Brandberg Y, Aamdal S, Bastholt L, et al. Health-related quality of life in patients with high-risk melanoma randomised in the Nordic phase 3 trial with adjuvant intermediate-dose interferon alfa-2b. Eur J Cancer. 2012; 48(13): 2012–2019.
  62. Brown PJ, Roose SP. Age and anxiety and depressive symptoms: the effect on domains of quality of life. Int J Geriatr Psychiatry. 2011; 26(12): 1260–1266.
  63. Nickel JT, Brown KJ, Smith BA. Depression and anxiety among chronically ill heart patients: age differences in risk and predictors. Res Nurs Health. 1990; 13(2): 87–97.
  64. Diener Ed, Suh E, Lucas R, et al. Subjective well-being: three decades of progress. Psychol Bull. 1999; 125(2): 276–302.
  65. Ryff CD. Possible selves in adulthood and old age: a tale of shifting horizons. Psychol Aging. 1991; 6(2): 286–295.
  66. Murphy JM, Olivier DC, Monson RR, et al. Incidence of depression and anxiety: the Stirling County Study. Am J Public Health. 1988; 78(5): 534–540.
  67. Cochran S, Rabinowitz F. Men and depression: clinical and empirical perspectives. Academic Press, Cambridge 1999: 208.
  68. Scherber RM, Senyak Z, Kosiorek HE, et al. Treating Depression in the Myeloproliferative Neoplasms: The Role and Implications of Poorly Controlled Symptoms and Psychosocial Factors. Blood. 2016; 128(22): 5474–5474.
  69. Baider L, Bengel J. Cancer and the spouse: gender-related differences in dealing with health care and illness. Crit Rev Oncol Hematol. 2001; 40(2): 115–123.
  70. Geyer HL, Kosiorek H, Dueck AC, et al. Associations between gender, disease features and symptom burden in patients with myeloproliferative neoplasms: an analysis by the MPN QOL International Working Group. Haematologica. 2017; 102(1): 85–93.
  71. Coyne JC, Smith DA. Couples coping with a myocardial infarction: a contextual perspective on wives' distress. J Pers Soc Psychol. 1991; 61(3): 404–412.

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