MPN-10 Symptom Assessment Form

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ASSESSMENT FORM

MPN-10 Symptom Assessment Form

MPN-10 Symptom Assessment Form is a symptom assessment tool that can assist MPN patients in monitoring their disease on their own. Before your next medical appointment, you may use the assessment form to record the change of the listed symptoms for your doctor's follow-up.

Please select a number from 0 to 10 to reflect the severity of the symptom. 0 is absent/as good as it can be and 10 is worst-imaginable. Please ensure that every number selected can accurately reflect your condition.

Symptom Severity
Please rate your fatigue (weariness, tiredness) by choosing the one number that best describes your WORST level of fatigue
during past 24 hours
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Choose the one number that describes how, during the past week how much difficulty you have had with each of the following symptoms
Filling up quickly when you eat (early satiety)
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Abdominal discomfort
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Inactivity
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Problems with concentration (compared with before the diagnosis)
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Night sweats
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Itching (pruritis)
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Bone pain (widespread, not joint pain or arthritis)
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Fever (>37.8°C or >100°F)
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
Unintentional weight loss (in the last 6 months)
0
1
2
3
4
5
6
7
8
9
10
Absent
Worst-imaginable
MPN-10 Total Score 0 point

MPN-SAF TSS items were designated as “moderate” if symptoms were rated as ≥ 4 of 10 or ≤ 6 of 10; and as “severe” if symptoms were rated as ≥ 7 of 10. For patients who completed at least six of these 10 items on the BFI and MPN-SAF, the MPN TSS was computed as the average of the observed items multiplied by 10 to achieve a 0-to-100 scale.

Additional information:

What are myeloproliferative neoplasms?

Myeloproliferative neoplasms include primary myelofibrosis (PMF), essential thrombocythaemia (ET) and polycythaemia vera (PV).2

Among them, primary myelofibrosis is a Philadelphia-negative classical MPN. This rare type of blood cancer is characterized by the overproduction of a specific type of blood cells in the body that disrupts the normal functioning of the body, resulting in scarring of the bone marrow (fibrosis) and spleen enlargement. Potential complications and symptoms include fatigue, fever, night sweats, itchy skin, bone pain, abdominal pain or discomfort, and weight loss.1 Prognosis of myelofibrosis is poor and treatment options are limited.3,4 About 10%-15% myelofibrosis cases begin with primary thrombocytosis or polycythemia. These cases are also known as secondary myelofibrosis.2

References :

  1. Emmanuel RM, et al. J Clin Oncol. 2012;30:4098-4103. 
  2. Leukemia & Lymphoma Society. Myeloproliferative Neoplasms. Available at https://www.lls.org/sites/default/files/2021-10/PS81_MPN_Booklet_2021.pdf (Last accessed: 15 Sep 2022).
  3. Mesa RA, et al. Leuk Res. 2009;33:1199-1203.
  4. Verstovsek S, et al. New Eng J Med. 2010;16(363):1117-1127.

Oncology Academy