Background: Myeloproliferative neoplasms (MPNs), a group of chronic hematologic malignancies, carry significant physical and psychological symptom burdens that significantly affect patients' quality of life. Objectives: We sought to identify the relationship between early childhood adversity (ECA) and psychological distress in patients with MPNs, as ECA may compound symptom burden. Methods: Patients with MPNs were assessed for ECA (i.e., the Risky Families Questionnaire-subscales include abuselneglectichaotic home environment), distress (i.e., Distress Thermometer and Problem List), anxiety (i.e., Hospital Anxiety and Depression Scale-Anxiety [HADS-A]), depression (i.e., Hospital Anxiety and Depression Scale-Depression [HADS-DJ), meeting standardized cutoff thresholds for distress (le., Distress Thermometer and Problem List >= 4 or >= 7) lanxiety (HADS-A 8) ldepression (HADS-D >= 8), and demographic factors. Results: A total of 117 participants completed the study (78% response rate). ECA was associated with depression (p < 0.000), anxiety (p < 0.000), and distress (pmyelofibrosis >essential thrombocythemia) (p = 0.047) and taking an antidepressant (p = 0.011). Conclusion: ECA is associated with psychological distress and meets screening criteria for anxiety and depression in patients with MPNs. ECA may help to explain individual patient trajectories, and further understanding may enhance patient-centered care among patients with MPNs.