Today's program is specifically for polycythemia or PV patients, and we'll be discussing the risks and concerns that you may have during the COVID-19 pandemic. We've had people on different therapies. All right, well, we'll get toward the end here. I also urge you to talk with your physician. Polycythemia vera is a condition characterized by an increased number of red blood cells in the bloodstream (erythrocytosis). Esther Schorr:Okay. One other thing I wanted to touch base with you about is I know that you are now located in what is kind of a former hotspot. Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by an increase in morphologically normal red cells (its hallmark), but also white cells and platelets; e Ten to 30% of patients eventually develop myelofibrosis and marrow failure; acute leukemia occurs spontaneously in 1.0 to 2.5%. So thank you very much for watching. If you don't need to come in and do a CBC for a couple of months, let's not do it." We're not out of the woods yet, but follow the rules. Coronavirus disease (COVID-19) has a wide spectrum of clinical manifestations. Dr. Scandura:There are a number of large efforts to try to collect this information, and right now we don't have data to draw from to say, "Patients with PV have a worse or better outcome than those without." It usually develops slowly, and you might have it for years without knowing. I would say apocryphally, it seems about the same. But that by no means indicates that giving Pegasys would be beneficial. One is the development of peptic ulcers, which are sores on the lining of your stomach, esophagus or small intestine, which may bleed into your gut. Esther Schorr:Okay. Polycythemia vera is a rare blood disease in which the body makes too many red blood cells, making the blood thicker than normal and causing blood clots. If I'm being honest, I'm still a little bit uncomfortable going to the hospital and just looking around and thinking I can get it any which way. We will continue to alert the community should this change. Polycythemia (say “paw-lee-sy-THEE-mee-uh) is an abnormal increase in red blood cells. Like at the beginning, I think that now patients have to take on this new 'trying to figure out risk versus benefit' of each of their procedures. I did not have a problem with it. So let's talk a little bit about stroke. I have one other question for you, Dr. Fleischman. So it's threading that needle. The other concern is stress. My wife is home. And last but not least, we have Nick Napolitano, who is a PV patient, and an amazing advocate. Polycythemia Vera market size has been evaluated to endure tough competition, wherein Jakafi is likely to maintain dominance in the hydroxyurea-refractory (second line) Polycythemia Vera market. In March, every other day we were doubling the number of cases, and that went on for over a month. The Leukemia and Lymphoma Society - Your Questions Answered about Coronavirus (COVID-19)Two hematologist/oncologists on the LLS leadership team, and experts in the field of blood cancer, answer questions and concerns about coronavirus (COVID-19). And I would say right now there's no evidence that patients with PV should be treated any differently than the general population. Coronavirus disease (COVID-19) has a wide spectrum of clinical manifestations. In that case, should they be worrying about stroke in that context, either during treatment or later on after treatment? So the lag is the opposite of what we see when people are getting sick, where if there's a number of positive tests, then the number of hospitalizations, then the number of ICUs start filling up, and then you start seeing the death numbers increase. Can you comment on how they've done in general, and maybe that's true with you too, Dr. Fleischman, just in general? Polycythemia vera is a chronic condition that can't be cured. He has a longstanding history of hypertension, diabetes, hyperlipidemia, cigarette smoking, and polycythemia vera (PV) with JAK2 V617F mutation for 7 years. Esther Schorr:And we talked about briefly before the program that it really sounds like the kind of advice or concerns that people may have that you have to address really varies geographically based on what's happening with the pandemic itself and what the capacities are. The increase in blood cells makes your blood thicker. So I don't think patients should change therapies just because of COVID, but just stay on what you are. I'm not losing my ability to oxygenate myself." There was a study from China from the early days where people with severe COVID who had dramatically increased evidence of hyper-activation of the coagulation system, that those people benefited from anticoagulation. In the spectrum of good to bad news, that's good news. The first is Dr. Angela Fleischman, who's an Assistant Professor, Department of Medicine, Division of Hematology/Oncology at UC Irvine Health. Esther Schorr:Do you have concerns about going, or have you gone? I feel left out. Wear a mask doesn't help you that much, but it does help the community. And having a month of not having labs done probably isn't going to hurt anybody, so let's kick the can down the road a little bit and see how things are before you come into the center where there's a risk. NORD's Financial Assistance Program - The National Organization for Rare Disorders (NORD®) launched a COVID-19 Critical Relief Program to provide much-needed assistance to members of the rare community affected by the COVID-19 pandemic. But as a PV patient, you also worry about progression. Open question to whoever wants to tackle that. Hydroxyurea was prescribed as a cytoreductive therapy. Esther Schorr:No, okay. I guess that's maybe to reduce the risk of having to go into the hospital or clinic, you know, taking it down to a lower number during this time. I mean, New York City, a month, six weeks ago, we were all going, "Oh, my goodness, what is going on?" So you know, it's been concerning, to say the least. The condition causes your blood to thicken. Treatment focuses on reducing your amount of blood cells. Under control treatment or later on after treatment PV patient, you 've treated some patients. 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