Dear Lindy,

Fatigue, like many other symptoms in our MPNs, is due to the chronic inflammation that is caused by our MPNs:

"Emerging data demonstrates clear relationships between individual MPN symptoms (fatigue, abdominal complaints, microvascular symptoms, and constitutional symptoms) and cytokines, particularly IL-1, IL-6, IL-8, and TNF-α."

"In polycythemia vera, patients demonstrate increased levels of IL-1RA, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IFN-γ, GM-CSF, MCP-1, MIP-1α, MIP-1β, HGF, IP-10, MIG, MCP-1, PDGF-BB, TNF-α, IFN-γ, and VEGF [25, 26]. Conversely, PV patients also demonstrate lower levels of EGF and RANTES. PV patients also had significantly elevated levels of IL-7, GM-CSF, MIP-1α, IP-10, MIG, eotaxin, IFN-γ, and VEGF in comparison to primary MF patients. On multivariate analysis, MIP-1β was shown to be associated with inferior survival. In addition, hemoglobin count correlated with IL-4 and MCP-1, hematocrit count correlated with TNF-α and MCP-1, lymphocyte count correlated with IL-6 and TNF-1, and JAK2V617F mutation status correlated with TNF-1 and PDGF-BB."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC46...

The substances listed in the text above are involved in inflammation. As we have higher levels of these substances compared to healthy people, our bodies are affected and we experience a higher level of fatigue, brain fog and pain.

My hopes are that a treatment will be found to tackle inflammation adequately over and above chemotherapy.

Best wishes,
Tatiana

Impact of Inflammation on Myeloproliferative Neoplasm Symptom Development

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619953/

Dear Ruth,

I am lucky to have access to information and to be in a community of people with other types of chronic illness who share a lot on information and new research. As they share with me, I owe it to them to share information and inform others.
There is so much need for interdisciplinary approach.

Solidarity 🌸
Tatiana

Kudos to you Tatiana for having such a tremendous understanding of the pathophysiology of MPN.
I am learning a lot from you.
Much appreciated!
Ruth