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This burden is intrinsically linked to MPN pathophysiology, including splenomegaly, inflammatory cytokine release, and microvascular dysfunction, underscoring the need for MPN-specific patient-reported outcome measures (PROMs) to quantitatively assess symptoms and sensitively capture treatment responses. Initial instruments such as the Myelofibrosis Symptom Assessment Form (MF-SAF) and MPN Symptom Assessment Form (MPN-SAF) evaluated both symptom burden and HRQoL. To meet regulatory standards for JAK inhibitor trials, subsequent versions, such as MF-SAF v2.0 and the MPN-SAF Total Symptom Score (TSS), shifted focus toward symptom-specific endpoints, with a\u2009\u2265\u200950% reduction in TSS (TSS50) considered a clinically meaningful response. To improve consistency and methodological rigor, the MF-SAF was further refined into version 4.0, which has served as a primary endpoint in pivotal trials such as MOMENTUM, often in combination with validated generic HRQoL instruments. These PROMs have played a pivotal role in securing regulatory approvals for agents such as ruxolitinib and momelotinib. While TSS50 remains the standard endpoint in clinical trials, its dichotomous nature presents limitations; emerging evidence suggests that evaluating TSS as a continuous variable may offer greater sensitivity in capturing treatment effects. In clinical practice, the MPN-SAF TSS is increasingly used to guide symptom monitoring and personalized decision-making. This review outlines the evolution, validation, and clinical impact of MPNs-symptom-specific PROMs, underscoring their growing role in delivering precision, patient-centered care.<\/jats:p>","DOI":"10.1007\/s10238-025-01830-9","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T04:59:08Z","timestamp":1761368348000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["From symptom scales to regulatory endpoints: the evolution and clinical impact of patient-reported outcome measures in myeloproliferative neoplasms"],"prefix":"10.1007","volume":"25","author":[{"given":"Meng","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyulong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"1830_CR1","volume":"346","author":"N Black","year":"2013","unstructured":"Black N. 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