Eckert, Ryan

Abstract Bone marrow transplant (BMT) is a curative procedure for patients with hematological malignancies, hemoglobinopathies, and errors of inborn metabolism. Survivors are not without symptom burden. The purpose of this study was to assess the feasibility of a 12-week online yoga intervention compared to an educational control group in survivors of allogenic BMT. Participants were recruited nationally. Consenting participants were assigned to online yoga or a podcast control. Yoga and control group participants were instructed to complete 12 weeks of 60 minutes/week of online yoga and podcasts, respectively. Study participants were asked to complete online questionnaires at baseline (wk 0), midpoint (wk 6), postintervention (wk 12), and follow-up (wk 20). Feasibility benchmarks included > 70% satisfied with intervention and > 70% intending to continue participating in online yoga (acceptability); > 70% of participants achieving > 42 minutes/week of online yoga (demand); > 70% completing all four questionnaires (practicality); and at least small effect sizes of the intervention on Lee Symptom Score, physical function, fatigue, anxiety, sleep disturbance, social functioning, pain interference, depression, and quality of life as compared to control group (limited efficacy). Seventy-two participants consented and enrolled in the study (yoga group n = 33; podcast group n = 39). Of the yoga group participants, 54.5% (n = 19) completed the postintervention questionnaire, with 73.7% (n = 14) indicating they were satisfied/very satisfied and 15.8% (n = 3) likely/very likely to continue online yoga. Yoga participation averaged 31.98 minutes/week across 12 weeks. Both groups experienced a significant improvement in the Lee Symptom Score (6.2%–8.7% improvement from baseline) and depressive symptoms (5.3%–6.6% improvement from baseline). The yoga group experienced a significant reduction in pain (6.1% from baseline), and the podcast group experienced a significant reduction in fatigue (6.4% improvement from baseline). Online yoga was not found to be feasible to deliver to this population of survivors of BMT. However, there was satisfaction with online yoga among the majority of survivors of BMT, and beneficial effects were experienced in the yoga group on Lee Symptom Score, depressive symptoms, and pain. Future research is needed to enhance our understanding of barriers to online yoga participation for survivors of BMT and to determine its efficacy.

Background: The COVID pandemic has resulted in significant changes many aspects of daily living. To understand the impact that COVID-19 has had on the myeloproliferative neoplasm (MPN) patient population, we conducted an internet based survey. Methods: Survey: This survey was hosted Mayo Clinic's secured REDCap system for online surveys with a link to the survey alongside a brief description posted via the www.mpnqol.com website, as well as other MPN organizational partners. Survey responses were completely anonymous. Questions included MPN-Total symptom score (TSS), NCCN distress thermometer (NCCN-DT), questions regarding impact on medical care, and questions from CDC COVID-19 community survey question bank regarding the impact of social distancing as well as changes in health behaviors. Distress thermometer, MPN-TSS, and/or questions related to the impact of COVID-19 on MPN treatment were analyzed by: MPN diagnosis, among those with ET, PV, or MF diagnoses; medication status; stay at home order; community spread; and country. Associations were tested using Kruskal-Wallis or Wilcoxon rank sum tests (for continuous variables) or Fisher Exact tests (for categorical variables). Analysis: Results: Patient Demographics (Table 1): 1560 people responded to the survey, 1217 were eligible for analysis. Median age was 62 (range: 21-93), and 298 (24.6%) respondents were male. There were respondents from USA, Australia, Canada, Netherlands, Ireland, and UK. 233 patients (19.2%) have myelofibrosis, 419 (34.6%) polycythemia vera and 543 (44.8%) essential thrombocythemia. At the time of the COVID outbreak, 1026 (84.3%) were on MPN directed medical therapy, including ruxolitinib (15.3%), interferon (14.7%), hydroxyurea (42.7%) and ASA (47.7%). 165 (13.6%) respondents received COVID testing, of which 5 had positive tests. Impact on MPN Care (Table 2): We sought to understand how patient's clinical care changed. Over half respondents who spoke to their MPN doctor had a telemedicine visit after COVID19 (57.1%). 422 (36.5%) patients spaced out visits, of which 99 (22.7%) felt there were consequences. A change in therapy due to COVID-1 occurred in only 5.4% of patients. MPN Symptom Burden and QoL: Data captured on the NCCN-DT had a median of 4 (0-10). MPN-SAF-TSS composite score was collected in 1150 respondents, median score was 26 (0-90). These scores are higher than those previously reported. Pandemic Impact on Lifestyle (Table 1): 595 (49.5%) of patients report living in a community where there is significant COVID-19 spread. 946 (78.9%) reported that COVID-19 has impacted their day to day life. 198 (17.2%) of patients agreed, or strongly agreed that COVID had a significant impact on their finances. 799 (67.8%) had a stay at home order. Of those who quarantined (112), the median duration was 30d (1-120). The majority of people increased hand-washing, and cleaning habits. 954 (81.7%) respondents reported wearing masks in public. 908 (76.8%) reported increased stress from social distancing. The majority of respondents report using healthy coping habits, such as reaching out to friends/loved ones, breathing and relaxation, as well as healthy diet. Less than 15% of patients report unhealthy coping strategies, such as use of opioids, benzodiazepines, alcohol, or cannabis Factors associated with response: There were no differences in responses based on type of MPN. If a patient was on medication, they were more likely to have spoken to their provider (p<0.001). If there was a stay at home order in place, there was a higher MPN-TSS score (p<0.001). If the respondent lived in an area of high community spread, they had a higher NCCN-DT score (p<0.001). Patients in the USA had a higher NCCN-DT score (p=0.001), were more likely to stretch out the duration of time between visits (p<0.001) and less likely to have a telemedicine visit (p<0.001). Although fewer respondents in the USA thought COVID-19 was a serious disease (p=0.02), a higher percentage of respondents wore masks (p <0.001). Conclusions: In our survey of MPN patients, there were many changes noted in clinical care. The use of telemedicine was common, and at least a third had significant changes in their care. Most experienced increased stress, however, employed healthy coping strategies. Only a minority of patients had a COVID test, and only 5 were positive, further data will be needed to understand the impact of COVID infection. Figure 1 Disclosures Harrison: Roche: Honoraria; Incyte Corporation: Speakers Bureau; Celgene: Honoraria, Research Funding, Speakers Bureau; Sierra Oncology: Honoraria; Promedior: Honoraria; Shire: Honoraria, Speakers Bureau; AOP Orphan Pharmaceuticals: Honoraria; Novartis: Honoraria, Research Funding, Speakers Bureau; Janssen: Speakers Bureau; Gilead Sciences: Honoraria, Speakers Bureau; CTI Biopharma Corp: Honoraria, Speakers Bureau. Pemmaraju:Affymetrix: Other: Grant Support, Research Funding; Plexxikon: Research Funding; Incyte Corporation: Honoraria; Roche Diagnostics: Honoraria; Blueprint Medicines: Honoraria; Novartis: Honoraria, Research Funding; SagerStrong Foundation: Other: Grant Support; DAVA Oncology: Honoraria; Samus Therapeutics: Research Funding; Cellectis: Research Funding; Daiichi Sankyo: Research Funding; Celgene: Honoraria; AbbVie: Honoraria, Research Funding; Stemline Therapeutics: Honoraria, Research Funding; MustangBio: Honoraria; LFB Biotechnologies: Honoraria; Pacylex Pharmaceuticals: Consultancy. Vannucchi:Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Incyte: Membership on an entity's Board of Directors or advisory committees; Blueprint: Membership on an entity's Board of Directors or advisory committees; Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AbbVie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Gupta:Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Sierra Oncology: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bristol MyersSquibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Incyte: Honoraria, Research Funding; Pfizer: Consultancy. Mascarenhas:Celgene, Prelude, Galecto, Promedior, Geron, Constellation, and Incyte: Consultancy; Incyte, Kartos, Roche, Promedior, Merck, Merus, Arog, CTI Biopharma, Janssen, and PharmaEssentia: Other: Research funding (institution). Shimoda:Kyowa Hakko Kirin Co., Ltd.: Research Funding; Pfizer Inc.: Research Funding; Otsuka Pharmaceutical: Research Funding; Celgene: Honoraria; Perseus Proteomics: Research Funding; PharmaEssentia Japan: Research Funding; AbbVie Inc.: Research Funding; Astellas Pharma: Research Funding; Merck & Co.: Research Funding; CHUGAI PHARMACEUTICAL CO., LTD.: Research Funding; Bristol-Myers Squibb: Honoraria; Takeda Pharmaceutical Company: Honoraria; Novartis: Honoraria, Research Funding; Shire plc: Honoraria; Asahi Kasei Medical: Research Funding; Japanese Society of Hematology: Research Funding; The Shinnihon Foundation of Advanced Medical Treatment Research: Research Funding. Kiladjian:AOP Orphan: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees. Komatsu:AbbVie: Other: member of safety assessment committee in M13-834 clinical trial.; Otsuka Pharmaceutical Co., Ltd., Shire Japan KK, Novartis Pharma KK, PharmaEssentia Japan KK, Fuso Pharmaceutical Industries, Ltd., Fujifilm Wako Pure Chemical Corporation, Chugai Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Takeda Pharmaceutica: Research Funding; Meiji Seika Pharma Co., Ltd.: Patents & Royalties: PCT/JP2020/008434, Research Funding; PPMX: Consultancy, Research Funding; Otsuka Pharmaceutical Co., Ltd., PharmaEssentia Japan KK, AbbVie GK, Celgene KK, Novartis Pharma KK, Shire Japan KK, Japan Tobacco Inc: Consultancy; Takeda Pharmaceutical Co., Ltd, Novartis Pharma KK, Shire Japan KK: Speakers Bureau. Abello:Takeda: Honoraria, Research Funding; Novartis: Consultancy, Honoraria; Amgen: Consultancy, Research Funding; Dr. Reddy's: Consultancy, Research Funding; Abbvie: Consultancy, Research Funding. Gomez-Almaguer:Amgen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AbbVie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AstraZeneca: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Scherber:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company. Mauro:Novartis: Consultancy, Honoraria, Other: Travel, Accommodation, Expenses, Research Funding; Bristol-Myers Squibb: Consultancy, Honoraria, Other: Travel, Accommodation, Expenses, Research Funding; Sun Pharma/SPARC: Research Funding; Takeda: Consultancy, Honoraria, Other: Travel, Accommodation, Expenses, Research Funding; Pfizer: Consultancy, Honoraria, Other: Travel, Accommodation, Expenses, Research Funding. Mesa:Samus Therapeutics: Research Funding; Novartis: Consultancy; Genentech: Research Funding; Incyte: Research Funding; Bristol Myers Squibb: Research Funding; AbbVie: Research Funding; CTI BioPharma: Research Funding; Sierra Oncology: Consultancy; LaJolla Pharmaceutical Company: Consultancy; Promedior: Research Funding.

Introduction: The delivery of online interventions in cancer patients/survivors has increased. The measurement of participation in online interventions is important to consider, namely, the challenges of the remote assessment of activity. The purpose of this study was to report the measures used to assess intervention compliance and other physical activity participation in two online yoga studies, the relationship between the multimethod measures used, and the ability of cancer patients to complete these measures. Methods: The methods described are of two online yoga studies (feasibility and pilot). Cancer patients were asked to participate in 60 min/week of online yoga for 12 weeks, complete a weekly yoga log, wear a Fitbit daily for 12 weeks, and complete a weekly physical activity log. Finally, Clicky®, a web analytics software, was used to track online yoga participation. Results: Eighty-four people participated across both studies, with 63/84 participating in online yoga, averaging 57.5 ± 33.2 min/week of self-reported yoga participation compared to 41.4 ± 26.1 min/week of Clicky® yoga participation (Lin concordance = 0.28). All 84 participants averaged 95.5 ± 111.8 min/week of self-reported moderate/vigorous physical activity compared with 98.1 ± 115.9 min/week of Fitbit-determined moderate/vigorous physical activity (Lin concordance = 0.33). Across both studies, 82.9% of the yoga logs were completed, the Fitbit was worn on 75.2% of the days, and 78.7% of the physical activity logs were completed. Conclusions: Weak relationships between self-report and objective measures were demonstrated, but the compliance rates were above 75% for the study measures. Future research is needed, investigating the intricacies of self-report physical activity participation in remote interventions and the validation of a gold standard measurement for online interventions.

AbstractMyeloproliferative neoplasms (MPNs) are characterized by significant symptom burden. Integrative medicine (IM) offers unique symptom management strategies. This study describes IM interventions utilized by MPN patients and the association with symptom burden, quality of life, depression, and fatigue adjusted for lifestyle confounders. MPN patients were surveyed online for IM utilization, MPN symptom burden (MPN‐Symptom Assessment Form Total Symptom Score), depression (Patient Health Questionnaire), fatigue (Brief Fatigue Inventory), and a single question on overall quality of life. Measures were compared by IM participation and adjusted for alcohol and tobacco use, BMI, diet, and MPN type using multiple linear and logistic regression. A total of 858 participants were included in the analysis. Aerobic activity (p =< 0.001) and strength training (p = 0.01) were associated with lower mean symptom burden while massage (p =< 0.001) and support groups (p =< 0.001) were associated with higher levels of symptom burden. Higher quality of life was reported in massage (p = 0.04) and support groups (p = 0.002) while lower quality of life was noted in aerobic activity (p =< 0.001) and strength training (p = 0.001). A lower depression screening score was noted in those participating in aerobic activity (p = 0.006), yoga (p = 0.03), and strength training (p = 0.02). Lower fatigue was noted in those participating in aerobic activity (p =< 0.001) and strength training (p = 0.03) while higher fatigue was noted in those participating in massage (p =< 0.001) and breathing techniques (p = 0.02). Data available on request from the authors. This international survey of MPN patients on IM usage, has shown that patients who participated in a form of IM had a pattern of decreased levels of symptom burden, fatigue, depression, and higher QoL, as adjusted for health lifestyle practices overall.

Abstract Background: Polycythemia vera (PV), essential thrombocytosis (ET), and myelofibrosis (MF) are chronic myeloproliferative neoplasms (MPNs) characterized by clonal cell proliferation, splenomegaly, and significant symptom burden. Integrative medicine interventions may offer unique symptom management strategies. (Gowin, et al., EHA 2017). Here we describe integrative interventions utilized and association with symptom burden, quality of life, depression, and fatigue adjusted for lifestyle confounders. Methods:Patients were recruited via social media. Consent and online self-report surveys were completed capturing patient demographics, disease-specific data, integrative medicine utilization, symptom burden via MPN-Symptom Assessment Form Total Symptom Score (MPN-SAF TSS), depression screening via Patient Health Questionnaire (PHQ)-2, fatigue via Brief Fatigue Inventory (BFI), and overall quality of life (QoL). MPN-SAF TSS, QoL, BFI, and PHQ2 were compared by participation in the most frequently utilized interventions (Yes vs No). Intervention comparisons were adjusted for alcohol consumption, smoking status, BMI, current dietary modification, and MPN type using multiple linear and logistic regression. Results: Patients: A total of1087 patient surveys were consented. Of these, 858 had 10 or more responses. See Table 1 for patient characteristics. Integrative Medicine Therapies Descriptive Analysis: Integrative medicine therapies most frequently utilized by patients included aerobic activity (51.5%), massage (28.4%), yoga (25.6%), nutrition (25.2%), strength training (23.8%), acupuncture (19.3%), meditation (19%), breathing exercises (18.4%), chiropractic (16.2%), support groups (14.5%), mindfulness based stress reduction (13.6%), walking meditation (12.0%), pet therapy (9.4%), aromatherapy (8.6%), music therapy (8.0%), progressive muscle relaxation (7.0%), guided imagery (6.4%), homeopathy (6.3%), manual therapy (osteopathy/cranial sacral) (6.2%), reiki (5.8%), therapeutic touch (5.7%), Tai Chi (5.2%), art therapy (4.9%), traditional Chinese medicine (4.3%), Qigong (3.5%), cooking classes (3.0%), laughter therapy (2.9%), Ayurveda (2.4%), biofeedback (2.2%), dance therapy (2.1%), hypnosis (2.0%), resilience training (0.9%), IV vitamin therapy (0.8%), and narrative medicine (storytelling) (0.3%).Diet modification was reported in 47.7% of patients, including Mediterranean diet (19.0%), paleo/high protein/low carbohydrate (8.9%), vegetarian (8.6), plant based (5.2%), gluten free (5.2%), low FODMAP (1.8%), vegan (1.2%), and raw (0.6%) diets. Only 24% of patients reported receiving nutrition advice from their healthcare practitioner (HCP). Supplement utilization by MPN type was 162 patients (48.4%)in ET, 80 patients (42.8%) in MF, and 142 patients (45.2%) in PV. Overall, 20.6% patients reported not disclosing their natural product usage to their HCP. The most frequently utilized supplements included vitamin D, multivitamin, magnesium, omega 3, and calcium. Adjusted symptom association with integrative therapy intervention: MPN symptom burden: Aerobic activity (P=<.001)and strength training (P=.01) was associated with lower mean symptom burden. Use of massage (P=<001) and support groups (P=<.001) was associated with higher levels of symptom burden. QOL:Higher quality of life was reported in those receiving massage (P=.04)and support groups (P=.002). Lower quality of life was noted in those using aerobic activity (P=<.001)and strength training (P=.001). Depression (PHQ-2):Lower depression screening score was noted in those participating in aerobic activity (P=.006), yoga (P=.03), and strength training (P=.02). Fatigue (BFI):Lower fatigue was noted in those participating in aerobic activity (P=<.001) and strength training (P=.03). Higher fatigue was noted in those participating in massage (P=<.001) and breathing techniques (P=.02). See Table 2. Conclusion: In a geographically diverse MPN patient population, and when adjusting for healthy lifestyle practices overall, patterns of lower symptom burden, fatigue, depression, and higher QoL were revealed with integrative medicine utilization. Although limited by gender discrepancy and patient reported data, this study may offer a foundation to structure future integrative medicine trials to complement standard therapies in MPN patients. Disclosures Gowin: Incyte: Consultancy, Other: Scientific Advisory Board, Speakers Bureau. Mesa:UT Health San Antonio - Mays Cancer Center: Employment; Promedior: Research Funding; NS Pharma: Research Funding; CTI Biopharma: Research Funding; Genentech: Research Funding; Gilead: Research Funding; Incyte Corporation: Research Funding; Novartis: Consultancy; Pfizer: Research Funding; Celgene: Research Funding.

Abstract Introduction: Polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF) are chronic, Philadelphia-negative myeloproliferative neoplasms (MPNs) that are characterized by deregulated myeloid lineage cell production, leading to a high symptom burden, including abdominal pain/discomfort from splenomegaly, fatigue, depressive symptoms, sleep disturbance, sexual problems, and pruritis, among other symptoms. Yoga interventions have been demonstrated to be efficacious for improving symptom burden in other cancer populations. Additionally weight has been shown to moderate symptom burden response in cancer patients. In MPN patients, it is unknown if weight influences symptom burden response. Therefore, the purpose of this analysis was to examine the differences at baseline and post-intervention in symptom burden between overweight and normal weight MPN patients participating in an online yoga intervention. Methods: MPN patients were asked to participate in 60 minutes of online-streamed yoga weekly for 12 weeks. Participants were asked to complete online self-report surveys administered via Qualtrics at baseline (week 0), mid-point (week 7), post-intervention (week 12), and follow-up (week 16). Survey measures included demographics, total symptom burden and fatigue (MPN Symptom Assessment Form [MPN SAF]) as well as NIH PROMIS measures of pain, anxiety, depression, sleep, and sexual function. BMI status was determined through self-report height and weight obtained in the baseline survey. For statistical analyses, BMI was dichotomized into an overweight (OW) category (BMI ≥25 kg/m2) and a normal weight (NW) category (BMI <25 kg/m2). Results: A total of 38 MPN patients completed the 12-week intervention. The majority of participants were diagnosed with either PV (n=16) or ET (n=16), with MF being less common (n=6). Median age was 56 years (range 29-72) with most participants being female (n=34). A minority were OW (n=12). At baseline, total symptom score (TSS) was descriptively higher in OW vs NW participants (mean 42.8 [SD 16.2] vs 32.7 [SD 10.9], p=0.06) with no other differences observed for PROMIS outcomes. OW participants had significantly improved TSS (p=0.002), anxiety (p=0.002), sleep (p=0.02), and vaginal discomfort (p=0.04) at the end of the intervention (week 12, Table 1). Improvements in NW participants did not reach statistical significance for any scales except sleep at week 12 (p<0.001). From baseline to follow-up (week 16), NW participants had significant improvements in TSS (p=0.003), depression (p=0.003), and sleep (p=0.007). OW participants maintained significant improvements in only sleep at week 16 (p=0.005). Conclusion: In MPN patients participating in a 12-week, online streamed yoga intervention, some differences in response to the intervention were observed between OW and NW participants. However, statistical power for definitive analysis of weight as a moderator for improvement in symptom burden was limited due to a small sample size. Considering the lack of interventions in MPN patients and the potential role that weight has on outcomes in other cancer populations, a randomized controlled trial investigating the effects of online yoga in a larger sample of MPN patients is warranted along with further investigation of effectiveness of the intervention within groups of participants by weight. Disclosures Gowin: Incyte: Membership on an entity's Board of Directors or advisory committees. Mesa:Promedior: Research Funding; Incyte: Research Funding; Ariad: Consultancy; CTI Biopharma: Research Funding; Novartis: Consultancy; Gilead: Research Funding; Galena: Consultancy; Celgene: Research Funding.

Abstract Introduction: Polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF) are Philadelphia-negative myeloproliferative neoplasms (MPNs) leading to risk of vascular events, splenomegaly and cytopenias in advanced disease as well as disease-originating symptoms, including (but not limited to) fatigue, depressive symptoms, insomnia, inactivity, sexual problems, and pruritis. Current therapy with JAK inhibition has improved MPN symptom burden, yet even in responders, unmet needs remain for alleviating fatigue, mood related symptoms, and insomnia. Yoga used as non-pharmacologic therapy has been shown to be efficacious for improving anxiety, depression, sleep quality, and fatigue in other cancer populations, including hematological malignancies. Due to a lack of this type of research in MPN patients, we undertook the first yoga study in this population as a feasibility trial (i.e., acceptability, demand, practicality) of home-based, online-streamed yoga for improving MPN patient symptom burden. Methods: MPN patients were recruited nationally using social media. Participants were asked to complete 60 minutes of online-streamed yoga weekly for 12 weeks. The yoga video selection included MPN-specific videos as well as others chosen specifically with potential splenomegaly in mind. Additionally, participants were asked to complete online self-report surveys administered via Qualtrics. Survey measures included demographics, total symptom burden and fatigue (MPN Symptom Assessment Form [MPN SAF]) as well as NIH PROMIS measures of pain, anxiety, depression, sleep, and sexual function. Surveys were administered at baseline (week 0), mid-point (week 7), post-intervention (week 12), and follow-up (week 16). Weekly yoga minutes were collected through online self-report. Results:Patients: Two hundred and forty-four MPN patients completed the eligibility survey, 134 were eligible, 55 completed the informed consent, and 38 MPN patients completed the 12-week intervention. The majority of participants were diagnosed with either PV (n=16) or ET (n=16), with MF being less common (n=6). Additionally, the majority of participants were female (n=34), Caucasian (n=37), married (n=30) of a normal BMI category (n=26), and had attained a Bachelor's degree or higher (n=25). Median age of those participating was 56 years (range 29-72). Yoga Participation & Safety:Approximately 37% (n=14) of study participants averaged ≥60 min/week of yoga. Yoga participation averaged 50.8±36.2 min/week. Additionally, 75% of participants felt safe from injury while participating in online yoga. Only one adverse event was reported (irritated enlarged spleen). Feasibility:Overall, 68% of participants were either satisfied or very satisfied with online yoga and 75% felt that is was helpful for coping with MPN-related symptoms (i.e., acceptability, practicality). However, only 43% of participants reported that they were likely or very likely to continue their online yoga practice (i.e., demand). Impact of Yoga Intervention: From baseline (week 0) to post-intervention (week 12, n=30), there were significant improvements in total symptom burden (effect size [ES] in standard deviation units=-0.36, p=0.004), anxiety (ES=-0.67, p=0.002), depression (ES=-0.41, p=0.049), sleep (ES=-0.58, p<0.001), and fatigue (ES=-0.33, p=0.04). These improvements remained significant at follow-up (week 16, n=28) for all outcome measures with a trend for maintained fatigue improvement (ES=-0.34, p=0.06). There were no significant differences in outcomes between those that averaged <60 min/week of yoga compared to those that averaged ≥60 min/week of yoga. Conclusions: A 12-week, home-based, online-streamed yoga intervention is feasible (i.e., accepted, practical) for MPN patients. Although the sample size was small and there was no control group, the results suggest that online yoga may be effective for improving MPN symptom burden, with statistically significant improvements observed in total symptom burden, fatigue, anxiety, depression, and sleep. A randomized, controlled trial is warranted to evaluate home-based, online-streamed yoga on MPN patient outcomes. If effective, yoga may represent a unique non-pharmacologic complement to standard therapies in a population with a heterogeneous symptom profile and significant symptom burden. Disclosures Gowin: Incyte: Membership on an entity's Board of Directors or advisory committees. Mesa:Ariad: Consultancy; Galena: Consultancy; Incyte: Research Funding; Gilead: Research Funding; Novartis: Consultancy; Promedior: Research Funding; CTI Biopharma: Research Funding; Celgene: Research Funding.

Myeloproliferative neoplasms (MPNs) are rare hematological malignancies with a significant symptom burden often left unresolved despite recent advances in pharmacological therapy. Yoga is a nonpharmacological strategy that has been shown to improve symptoms in other cancers and may be effective for improving symptoms in MPN patients. Online yoga helps address many of the commonly reported barriers of cancer patients to in-person interventions and may make yoga more accessible to MPNs. An exploration of MPN patient perceptions of participation in online yoga is needed to tailor interventions to patient needs and inform future studies. The purpose of this study was to explore the perceptions of MPN patients participating in a 12-week online yoga intervention. This article represents the combined qualitative interview data from two studies. Participants were asked to complete 60 min/wk of online, home-based yoga and were asked to participate in a 15- to 20-minute phone interview postintervention. The qualitative data was coded in NVivo 11 for content analysis. The total sample included 39 MPN patients. Online yoga was well accepted and liked among these patients. They reported physical (eg, improved sleep, reduced fatigue) and mental (eg, reduced stress) health benefits and liked the convenience of being able to do yoga at home. Online yoga provides a feasible and attractive format through which to deliver a nonpharmacological intervention among MPN patients. Randomized controlled trials are needed to confirm the effects of online yoga on MPN patient symptoms. The qualitative findings presented here help inform the development of these future trials.

e21704 Background: Patients with myeloproliferative neoplasms (MPN) have difficult symptom burden (i.e. fatigue, pruritus, night sweats) not resolved by current medical therapies including jak inhibitor therapy. We hypothesize that on-line (at home) yoga might alleviate MPN symptoms and complement medical therapy. Methods: MPN patients, recruited by social media, were asked to complete 60 min/week of online yoga (designed for MPN patients) for 12 weeks and completed online self-report surveys (weeks 0,7,12 and 16) on participation (Qualtrics), disease features, and symptom burden (MPN Symptom Assessment Form; NIH PROMIS measures of pain, anxiety, depression, sleep, and sexual function). Results: Two hundred and forty-four MPN patients completed the eligibility survey, 134 were eligible, 55 completed the informed consent, and 38 MPN patients completed the 12-week intervention. The majority of participants were diagnosed with either PV (n = 16) or ET (n = 16), with MF being less common (n = 6). Approximately 37% (n = 14) of study participants averaged ≥60 min/week of yoga (i.e., demand). Yoga participation averaged 50.8±36.2 min/week. Overall, 68% of participants were satisfied with online yoga and 75% felt that is was helpful for coping with MPN-related symptoms (i.e., acceptability, practicality). Additionally, 75% of participants felt safe from injury while participating in online yoga. Only one adverse event was reported (irritated enlarged spleen). From week 0 to week 12 (n = 38), there were significant improvements in total symptom burden (effect size [ES] in standard deviation units = -0.36, p = 0.004), anxiety (ES = -0.67, p = 0.002), depression (ES = -0.41, p = 0.049), sleep (ES = -0.58, p < 0.001), and fatigue (ES = -0.33, p = 0.04). These improvements remained significant at follow-up week 16 (n = 28) for all outcome measures with a trend for maintained fatigue improvement (ES = -0.34, p = 0.06) (see Table 1). There were no significant differences in outcomes between those that averaged < 60 min/week of yoga compared to those that averaged ≥60 min/week of yoga. Conclusions: A 12-week online yoga intervention is feasible (i.e., accepted, practical) for MPN patients and merits a randomized trial as complementary therapy.

e21684 Background: Pharmacologic therapy stabilizes hematologic counts and splenomegaly in myeloproliferative neoplasms (MPN), however only partial symptom improvement typically occurs. Evidenced-based supportive care interventions are needed, however data is limited in patients with MPNs. Methods: Patients were recruited internationally via social media. Informed consent and online self-report surveys (Qualtrics) were completed capturing patient demographics, disease specific data, supportive care utilization, and symptom burden via MPN-SAF TSS. ANOVA, chi square tests, and Wilcoxon rank sum tests methods were applied. Results: Patients:1087 patient surveys were consented. Of these, 858 had 10 or more responses. There were 338 essential thrombocytosis (ET), 188 myelofibrosis (MF), 315 polycythemia vera (PV), and 17 other. In MF: DIPSS risk categories included low (8%), Int-1 (19%), Int-2 (29%), high (12%), and unknown (32%). Supportive care:The most frequently utilized therapies were aerobic activity in 442 patients (51.5%), massage in 244 (28.4%), yoga in 220(25.6%), nutrition in 216 (25.1%), and strength training in 204 (23.7%). Symptom association: Among all respondents, aerobic activity (p=<0.001), massage (p=<0.001), yoga (p=0.02), and strength training (p=<0.001) was associated with lower symptom burden by the MPN-SAF TSS however, nutrition was not (p=0.10). In ET and PV subgroups, yoga intervention was no longer statistically significant (p=0.35, p=0.14). In the MF subgroup, no intervention was found to be significant in any risk category. Conclusions: Supportive care with aerobic activity, massage, yoga, and strength training is associated with improved symptom burden in patients with MPN. Further studies are needed to understand the benefits of such therapies. [Table: see text]