Nutritional status appears to accurately predict survival in patients with myelofibrosis (MF), according to a recently published study in Frontiers in Nutrition.
MF is a chronic myeloproliferative neoplasm characterized by bone marrow fibrosis and systemic inflammation. The disease often presents with symptoms like fatigue, splenomegaly, and early satiety. Inflammatory cytokines, a hallmark of MF, induce metabolic changes that frequently lead to malnutrition or even cachexia. Despite the established importance of nutritional status in oncology, its role in MF outcomes has remained underexplored until now.
Increasing evidence suggests that body composition and energy expenditure independently influence survival, underscoring the need for integrating nutritional care into disease management.
To address this gap, the study’s authors followed 45 patients with MF over an average of 31 months, comparing their nutritional parameters with 351 healthy controls.
Detailed assessments included body composition through bioelectrical impedance analysis, resting metabolic rate via indirect calorimetry, and dietary intake through validated food frequency questionnaires. The researchers also recorded prognostic markers such as the phase angle, spleen size, and the Dynamic International Prognostic Scoring System (DIPSS) score.
Patients with MF showed significantly lower phase angle values than healthy individuals (P <.001). They also had higher resting metabolic rates when normalized for fat-free mass (P <.001).
Patients with lower phase angle values and larger spleen size had significantly worse survival. In fact, low phase angle was as predictive of mortality as traditional clinical markers like fibrosis grade and DIPSS score. Additionally, deceased patients exhibited higher energy expenditure but lower actual energy intake, a pattern consistent with cancer-related cachexia.
Multivariate analysis confirmed that phase angle was independently associated with age, hand-grip strength, fat-free mass index, and spleen length. Interestingly, a longer spleen was also associated with lower cholesterol levels, hinting at a potential role of the spleen in lipid metabolism.
“Nutritional factors related to body composition and energy expenditure are important predictors of survival in individuals with MF, independent of other clinical indicators such as splenomegaly, bone marrow fibrosis, or circulating blasts,” the authors concluded.
This article originally appeared on Rare Disease Advisor
