PP386 - INFLAMMATORY-CATABOLIC MECHANISMS UNDERLYING ANOREXIA IN MYELOFIBROSIS: EVIDENCE BEYOND SPLENOMEGALY

PP386

INFLAMMATORY-CATABOLIC MECHANISMS UNDERLYING ANOREXIA IN MYELOFIBROSIS: EVIDENCE BEYOND SPLENOMEGALY

C. Gallicchio^1,*, F. Tambaro¹, G. Imbimbo¹, S. Orlando¹, E. Scalzulli¹, A. Molfino², M. Breccia¹, M. Muscaritoli¹

¹Department of Translational and Precision Medicine, ²Department of Interdisciplinary Studies on WellBeing, Health and Environmental Sustainability (BeSSA), Sapienza University of Rome, Rome, Italy

Rationale: Myelofibrosis (MF) is myeloproliferative disorder characterized by systemic inflammation and high prevalence of cachexia-related symptoms, including anorexia (AN). Although appetite impairment in MF is mainly attributed to splenomegaly-related early satiety, the contribution of inflammatory and metabolic pathways remains poorly understood. We aimed to investigate the nutritional and inflammatory features associated with AN in patients with MF.

Methods: We performed a cross-sectional analysis of 25 MF patients at baseline. AN was defined as FAACT score ≤30. Symptom burden was assessed using the MPN10 score, and performance status was evaluated according to the ECOG scale. Spleen diameter was assessed by abdominal ultrasonography. Circulating cytokines were quantified using multiplex magnetic Luminex assay. 

Results: AN was observed in 8 of 25 patients (32%). Anorexic patients were older(p=0.014), had lower hemoglobin levels (p=0.016), higher C-reactive protein (CRP) levels (p=0.042), greater weight loss(p=0.023), worse performance status (ECOG,p=0.030),and higher symptom burden (MPN10,p=0.002). Splenomegaly was present in 24 of 25 patients (96%). However, spleen diameter did not differ significantly between AN and non-AN patients(16 ± 2 vs 17.5 ± 0.7 cm, p=0.401),and no correlation was observed between FAACT score and spleen size (p=0.673).Among circulating cytokines,TNF-α was higher in AN patients vs non-AN patients (p=0.043), whereas no significant between-group differences were observed for IL-1β, IL-6, or IL-10.In addition, FAACT score inversely correlated with growth differentiation factor-15 (GDF-15) (p=0.027) and CRP(p=0.042).

Conclusion: AN in MF may not be solely attributable to splenomegaly-related satiety, but may also reflect an inflammatory-catabolic phenotype, supported by higher TNF-α levels and by an inverse association between appetite and serum GDF-15. 

Disclosure of Interest: None declared