PV Management Question 4
Transcript
The correct answer here is persistent leukocytosis can be part of a broader pattern of active disease, including symptoms and splenomegaly, and may help identify patients who need closer management. The rationale behind this is that elevated white cells, as a persistent leukocytosis, represent the marker of active disease and should, alongside increased splenomegaly, worsening symptoms, or otherwise disease burden, be considered for initiation of cytoreductive therapy. The post hoc analysis of the REVEAL study that evaluated association of blood counts and symptom burden showed that uncontrolled leukocytosis is significantly associated with higher symptom burden in patients with polycythemia vera and should be, alongside other symptoms such as severe itching or intolerance of phlebotomy, considered as one of the reasons to initiate cytoreductive therapy in these patients.
References
- Marchetti M, Vannucchi AM, Griesshammer M, et al. Appropriate management of polycythaemia vera with cytoreductive drug therapy: European LeukemiaNet 2021 recommendations. Lancet Haematol. 2022;9(4):e301-e311. doi:10.1016/S2352-3026(22)00046-1
- ELN 2021 guideline recommendations for polycythemia vera. MPN Hub. May 10, 2022. Accessed April 15, 2026. https://mpn-hub.com/medical-information/eln-2021-guideline-recommendations-for-polycythemia-vera
- Gerds AT, Mesa R, Burke JM, et al. Association between elevated white blood cell counts and thrombotic events in polycythemia vera: analysis from REVEAL. Blood. 2024;143(16):1646-1655. doi:10.1182/blood.2023020232
- Grunwald MR, Burke JM, Kuter DJ, et al. Symptom burden and blood counts in patients with polycythemia vera in the United States: an analysis from the REVEAL study. Clin Lymphoma Myeloma Leuk. 2019;19(9):579-584.e1. doi:10.1016/j.clml.2019.06.001
© 2026 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Oncology Learning Network or HMP Global, their employees, and affiliates.
Dr Masarova is an associate professor in the Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX. She is also co-leader of Myeloproliferative Neoplasms Session, Division of Cancer Medicine, at MD Anderson. Dr Masarova earned her medical degree from Comenius University Bratislava School of Medicine, Bratislava, Slovakia, and completed research and clinical fellowships in Leukemia at UT MD Anderson. While in Slovakia, Dr Masarova actively collaborated with researchers from other European sites to co-develop the largest Central European database of invasive fungal infections. She is a highly motivated physician, pursuing an academic, translational-research career while expanding her broad knowledge, training, and expertise in oncology and hematology. Her research includes various aspects of hematologic malignancies, with special interest in infections, immune system involvement, and influence of disease background and therapies on their outcome. Dr Masarova has completed many research projects and first-authored several manuscripts in peer-reviewed journals in addition to presenting her research at large Hematologic and Oncologic Conferences worldwide.
