Dr Grunwald on a Real-World Study of Risk Factors For Disease Progression in PV

Michael R. Grunwald, MD, chief, Leukemia Division, director, Transplantation and Cellular Therapy Program, Atrium Health’s Levine Cancer Institute; clinical professor, hematology and oncology, Wake Forest University School of Medicine, Bowman Gray Center for Medical Education, discusses findings and implications from a real-world observational study investigating risk factors related to disease progression in patients with polycythemia vera (PV).

Notably, these findings were presented at the 2024 EHA Congress. Five key risk factors were identified that distinguish patients with PV who experienced disease progression from those who did not, Grunwald begins. The first risk factor was an elevated white blood cell count, which is commonly associated with more aggressive disease. The second was a history of thrombosis, indicating that patients who had experienced blood clots were at higher risk of disease progression. The third factor was an elevated variant allele frequency of the JAK2 mutation, which indicates a higher burden of this specific mutation in patients who developed more severe disease, he reports.

The fourth factor was the time between diagnosis and enrollment in the study, which differed between the transformed and non-transformed patient populations, indicating that the length of time a patient has had the disease might influence their risk of progression, he continues. Finally, a hematocrit level of 0.45 L/L or lower was identified as a risk factor for progression, although this may have been influenced by other variables, as many of these patients were already receiving cytoreductive therapy, Grunwald reports.

Investigators believe that the risk factor of lower hematocrit levels could have been confounded by other factors, as many patients with lower hematocrit levels were already receiving cytoreductive therapy and had a longer time between diagnosis and study enrollment, he explains. Some of these patients might have already been in the early stages of myelofibrosis when they entered the study, Grunwald concludes.