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Presentations of elevated blood cell levels in PV

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Polycythemia vera is a disease that involves a stem cell and so, therefore, you’re gonna have increased numbers of red cells, increased numbers of white cells, and increased numbers of platelets. Now, the disease is very variable in that regard. You can have patients who have the JAK2V617F mutation that only have erythrocytosis. They’re not common but they can live; we’ve seen them for at least 10 years or more. Then you will have patients who have an elevation of the red cells and the platelets, okay, and not the white cells. When I see that, I find that generally is a clue that they’re gonna do very well. Then you have patients who come in and they’re making too many red cells, too many white cells, and too many platelets. They have the more sort of aggressive-type disease in a way; they’re more likely to get splenomegaly and do things, you know, in a more aggressive fashion. So polycythemia vera comes in all flavors. Now, the important thing to remember is that it’s not the platelets or the white cells that determine prognosis, it’s the stem cell.

head shot of Dr Spivak
Jerry Spivak, MD Professor of Medicine and Oncology Director Center for the Chronic Myeloproliferative Disorders Johns Hopkins University School of Medicine | Baltimore, MD
Dr Jerry Spivak is a researcher and professor of medicine and oncology at Johns Hopkins University School of Medicine. He has served as a member and director on multiple boards, including the International Society of Hematology, and has been published in over 230 scientific and clinical journals. Among the awards Dr Spivak has received are a Research Career Development Award and a Merit Award from the National Institutes of Health.