Dr. Michael Grunwald at ASH 2017 Patient Reported Symptom Burden and Peripheral Blood Counts Among Polycythemia Vera Patients

An Analysis and Surprising Findings from the REVEAL Study

First in ASH 2017 Series

by David Wallace

Dr. Michael Grunwald is Associate Director, Leukemia Division, Department of Hematologic Oncology and Blood Disorders at Levine Cancer Institute in Charlotte, NC.  Dr. Grunwald and David Wallace discuss an analysis on the REVEAL Study along with some “surprising findings.”


Summary of Key Points:

  • “Surprising Finding” – symptom burden did not come down as one would expect even when blood counts were controlled.
  • Although my numbers (CBC) indicate CHR (complete hematological remission) for the last 11 months, I wondered why my fatigue and PV fog / lack of mental clarity still persisted.  Dr. Grunwald pointed out the disease is still present, even when the blood counts are controlled.
  • There are other features of the disease beside blood counts.  Possible symptoms from treatment, as well as an inflammatory component.  There is no clinical test for inflammation in PV, but increased cell turnover does not go away, even when the counts are controlled.
  • CHR – symptoms can linger, not a cure for the disease, but helps lower HCT (hematocrit) under 45.  We need better treatments.  Lower HCT reduces risk of thrombosis.  Even in remission, patients can still be at risk for progression.
  • Remission is not equal to a cure.
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