I’m not qualified to answer that, I have found that getting spleen to
shrink is a priority and and then although bloods are unstable continue
with meds and watch and wait with monthly blood tests for a change that
require a bmb.

What I got from the video is that there is little evidence that platelet count normalisation reduces the risk of thrombosis, but that reducing WBC and hematocrit is important to prevent thrombosis. I appended a screenshot from the presentation regarding the normalisation of thrombocytes.

Regarding the dysfunctional blood cells, the researcher mentioned interferon towards the end of the presentation as a potential treatment that could remove the mutant clone or reduce it so much that it is undetectable, that could induce a molecular response in JAK2V617F mutated patients. This means it could alter the disease itself.

Your allele burden (often reported as VAF% in genetic tests) tells you what percentage of your blood cells are affected by said mutation. Whether you have 500000 platelets or 350000 platelets, the ratio of non mutated to mutated platelets in your blood will remain the same. So irrespective of cytoreduction, you will still have the same ratio of mutated versus non mutated blood cells. Except if one has a molecular response to interferon, which means the ratio between mutated versus non mutated cells moves towards fewer mutated cells as compared to before treatment.

This is a very simplified answer. Regarding allele burden and impact on disease, you can find more information on the page below:
https://bloodcancerstoday.com/post/is-whole-blo...

Is VAF a Useful Prognostic Biomarker for MPN? | Blood Cancers Today

https://bloodcancerstoday.com/post/is-whole-blood-allele-frequency-a-useful-prognostic-biomarker-for-mpn