Differences between aquagenic and non-aquagenic pruritus in myeloproliferative neoplasms: An observational study of 500 patients.

Abstract

BACKGROUND:

Pruritus is a frequent symptom experienced by patients with myeloproliferative neoplasms (MPN). Aquagenic pruritus (AP) is the most common type. The Myeloproliferative Neoplasm-Symptom Assessment Form Total Symptom Score (MPN-SAF TSS) self-report questionnaires were distributed to MPN patients before consultations.

OBJECTIVES:

The aim of this study was to assess clinical incidence (phenotypical evolution and response to treatment) of pruritus, especially AP, in MPN patients during their follow-ups.

PATIENTS AND METHODS:

We collected 1444 questionnaires from 504 patients [54.4% essential thrombocythaemia (ET) patients, 37.7% polycythaemia vera (PV) patients, and 7.9% primary myelofibrosis (PMF) patients].

RESULTS:

Pruritus was reported by 49.8% of the patients, including 44.6% of AP patients, regardless of type of MPN or driver mutations. Patients suffering from pruritus were more symptomatic and had a higher rate of evolution into myelofibrosis/acute myeloid leukaemia (19.5% vs. 9.1%, OR = 2.42 [1.39; 4.32], p = 0.0009) than MPN patients without pruritus. Patients with AP had the highest pruritus intensity values (p = 0.008) and a higher rate of evolution (25.9% vs. 14.4%, p = 0.025, OR = 2.07) than patients with non-AP. Disappearance of pruritus was observed in only 16.7% of AP cases, compared to 31.7% of cases with other types of pruritus (p < 0.0001). Ruxolitinib and hydroxyurea were the most effective drugs to reduce AP intensity.

CONCLUSIONS:

In this study, we demonstrate the global incidence of pruritus across all MPN. Pruritus, especially AP, which is a major constitutional symptom observed in MPN, should be assessed in all MPN patients due to higher symptom burden and higher risk of evolution.

• Authors: Christelle Le Gall-Ianotto, Anne-Sophie Ficheux, Eric Lippert, Laura Herbreteau, Laetitia Rio, Brigitte Pan-Petesch, Laurent Misery, Jean-Christophe Ianotto
• Journal: Journal of the European Academy of Dermatology and Venereology : JEADV (J Eur Acad Dermatol Venereol) Vol. 37 Issue 6 Pg. 1175-1183 (Jun 2023) ISSN: 1468-3083 [Electronic] England
• PMID: 36808754 (Publication Type: Observational Study, Journal Article)
• Copyright: © 2023 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Chemical References

• Hydroxyurea
• Water

Topics

• Humans
• Hydroxyurea (therapeutic use)
• Myeloproliferative Disorders (complications)
• Polycythemia Vera (complications)
• Primary Myelofibrosis (complications)
• Pruritus (etiology, diagnosis)
• Water (adverse effects)