Pennsylvania Cancer Clusters – Update

Background

In 2004, using state cancer registry records, the Pennsylvania Department of Health (PADOH) found a PV cluster in northeast Pennsylvania. PV is part of a disease group called myeloproliferative neoplasms (MPN), which is a group of slow-growing blood cancers where the bone marrow makes too many red blood cells, white blood cells, or platelets.

In 2006, ATSDR was asked to help study PV patterns in the area. From 2007-2008, ATSDR reviewed medical records, conducted genetic testing, and confirmed this PV cluster.

In 2009, Congress funded ATSDR to continue this investigation. ATSDR is overseeing 18 projects with PADOH, the Pennsylvania Department of Environmental Protection, and various universities and private organizations. These projects are based on recommendations from an expert panel. The panel identified four areas for investigation; epidemiology, genetics, toxicology, and environmental studies.

Status

As of October 1, 2013, all but one of the contracts for the 18 projects have ended.  The one exception is the tissue bank, which will remain open for recruitment of new tissue donations from the PA tri-county study area through May 2014.  After May 2014, no new samples will be added from the tri-county study area, but the geographically identified (but de-identified in terms of personal information) donations from the tri-county study area will continue to be available for researchers to access via this national tissue bank established at the Myleloproliferative Disease Research Consortium (MPD-RC).  You can continue to follow the work of the overall MPD-Research Consortium on their website at: http://www.mpd-rc.org/home.php.

The graphic with this email provides this summary as of April 2014.  I’ve attached this graphic both as a “snapshot” in the body of this email, as well as a pdf attachment.  Projects highlighted in “green” in the attached graphic have work complete and a final product available (if applicable).  Projects highlighted in “yellow” have final products in progress and undergoing clearance.  Projects highlighted in “red” have final products that are anticipated but not yet started.

As of May 8, 2014, work is complete and a final product is available (if applicable) for projects.  We are happy to announce that one new project (#3) moved from yellow to green since my October update; we now have a factsheet and final publication analyzing the accuracy of PV diagnoses using Geisinger Medical Center’s electronic medical records.  This is an important study that highlights that inconsistencies in PV diagnoses and record keeping remain despite more widespread use of the JAK2 genetic marker.   These documents are available at:

http://www.atsdr.cdc.gov/sites/polycythemia_vera/docs/fact_sheet_for_manuscript_determination_of_accuracy_of_pv_diagnoses_and_JAK2V617F_test_usage.pdf

http://www.atsdr.cdc.gov/sites/polycythemia_vera/docs/manuscript_determination_of_accuracy_of_pv_diagnoses_and_use_of_the_JAK2V617F_test_in_the_diagnostic_scheme.pdf

Note, one of the projects (#1) that was green in my October update moved to yellow since we are now expecting a journal publication for that effort when we were not before.  Final products for another 11 projects are in progress; this is an increase in two projects moving from red to yellow since my October update.  Final products for 2 projects are anticipated but not yet started (this is a decrease from 4 in this red stage in my October update).

I want to take a personal moment to acknowledge the work of our colleague Dr. Paul Roda.  He was the primary author for the work in project #3 that is now available for your review, as well as for projects #1 and #2.  Dr. Roda passed away suddenly in November 2013, and I really miss working with him.  I am so glad to share some of the results of his work with you.  This work remains a testimony to his dedication to this investigation and his profession of hematology.

For more information:

Visit ATSDR’s web page on PV: http://www.atsdr.cdc.gov/sites/polycythemia_vera/index.html

Call ATSDR’s toll-free PV information line: 866-448-0242 or email jcx0@cdc, which will connect you to Dr. Elizabeth Irvin-Barnwell, ATSDR Division of Toxicology and Human Health Sciences.

Contact Lora Siegmann Werner, ATSDR Region 3, by phone at 215-814-3141 or by email at lkw9@cdc.gov.

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