Polycythemia vera (PV) is a rare blood cancer. Erythrocytosis in the general population: clinical characteristics and association with clonal hematopoiesis. Chen, Fangfang (2013) Polycythemia Vera: An Investigation of Influential Factors for Death Rates Between 1962 and 2009. Hemorrhagic complications occur in 15-35% of patients and lead to death in 6-30% of these patients. Polycythemia vera treatments help reduce your risk of symptoms and complications. [Medline] . Master's Thesis, University of Pittsburgh. Mortality and causes of death of patients with polycythemia vera: analysis of the reveal prospective, observational study. University of Pittsburgh . 1 Study design. These extra cells cause the blood to be thicker than normal, increasing the risk for blood … The 15-year survival of patients with polycythemia vera is 65%. Polycythemia vera is an uncommon myeloproliferative neoplasm in which the bone marrow makes too many red blood cells. If you wish to read unlimited content, please log in or register below. Ann Intern Med 1995; 123:656. Results: Polycythemia vera is a condition characterized by an increased number of red blood cells in the bloodstream (erythrocytosis). A: Patients being treated for polycythemia vera can be expected to live between 11 and 15 years on average after diagnosis.. We hope you’re enjoying the latest clinical news, full-length features, case studies, and more. December 2020 Update. Methods: The medical records of 146 patients with the diagnosis of polycythemia between 1977 to 1990 were reviewed. The incidence rate for men is 2.8 per 100,000 person-years, and is 1.3 per 100,000 person years for women. Prevalence. Polycythaemia vera is a rare condition that tends to be slightly more common amongst men and people of Jewish ancestry. Polycythemia Vera – What Is PV, Symptoms, Diagnosis & Treatment Ever since we were born, very few of our cells remained the same, and they are mostly neurons (nerve cells). Is life expectancy of polycythemia vera patients clearly different from that of the general population? The incidence rate for men is 2.8 per 100,000 person-years, and is 1.3 per 100,000 person years for women. Learn about the JAK2 genetic mutation that … Acquired mutations in JAK2 (JAK2 V617F and exon 12 mutations) are found in nearly all patients with polycythemia vera. Polycythemia vera is also accompanied by shortness of breath and this problem will become more pronounced when the patient is lying down. While Polycythemia vera isn't curable, and research does show that the life expectancy of Polycythemia vera patients is lower than that of the general population (especially if the disease is diagnosed before age 50), you may be interested to hear that there is a 65 percent 15-year survival rate. Cancers (Basel). The presentation discusses a multicenter, noninterventional, prospective observational study of patients with polycythemia vera (PV) in US clinical practices, specifically in relation to mortality and causes of death. Read Full Story. However, its precise role as the cause of the disease is still under study. Many patients live far longer than that, as well. FS13 Polycythemia Vera Facts I page 1 Revised April 2015 Causes The cause of PV is not fully understood. De Stefano V, Za T, Rossi E, Vannucchi AM, Ruggeri M, Elli E, Micò C, Tieghi A, Cacciola RR, Santoro C, Gerli G, Vianelli N, Guglielmelli P, Pieri L, Scognamiglio F, Rodeghiero F, Pogliani EM, Finazzi G, Gugliotta L, Marchioli R, Leone G, Barbui T; GIMEMA CMD-Working Party. Blood Cancer Journal 2015;5:e366. Elhassan AM, Alsaud A, Yassin MA, Aldapt M, Riaz L, Ghori F, Bin Ahmad A, Abdulla M. Case Rep Oncol. In fact, neonatal polycythemia can happen to 1 to 5 percent of all newborn. - Drug Monographs CHIEVITZ E, THIEDE T. Complications and causes of death in polycythaemia vera. The impact of clinicopathological studies on staging and survival in essential thrombocythemia, chronic idiopathic myelofibrosis, and polycythemia rubra vera. This mutated gene likely plays a role in the onset of PV. by . A total of 236 deaths (33%) were recorded for an overall mortality rate of 7.73 deaths per 100 patient-years. The prevalence of PV is estimated to be 44 to 57 cases per 100,000 persons, and approximately 148,000 persons are living with PV in the United States. This condition may not cause any symptoms in its early stages. (Unpublished) 2020 Oct 9;12(10):2891. doi: 10.3390/cancers12102891. USA.gov. Zu den Hauptsymptomen zählen eine verm… Randi ML, Fabris F, Ruzzon E, Pacquola E, Cella G, Girolami A. Semin Thromb Hemost. Certain mutations (mostly spliceosome) and abnormal karyotype might compromise survival in PV and ET. Polycythemia vera treatments help reduce your risk of symptoms and complications. Please login or register first to view this content. Am J Med. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you | Tefferi A, Barbui T. Polycythemia vera and essential thrombocythemia: 2017 update on diagnosis, risk-stratification, and management. Disclosure: Some authors have declared affiliations with or received funding from the pharmaceutical industry. There’s no cure, but you can control PV through treatment. Purpose: The clinical course of polycythemia vera is often complicated by thrombosis as well as by the possible transition to myeloid metaplasia with myelofibrosis or acute myeloid leukemia. The increase in blood cells makes the blood thicker, leading to strokes or tissue and organ damage. Polycythemia vera and some similar disorders have, ... Clots may occur in the small arteries of the toes and fingers, leading to pain, warmth, tissue death (gangrene) and/or classic erythromelalgia. Polycythemia vera: the natural history of 1213 patients followed for 20 years. Some people with polycythemia vera experience headaches, dizziness, ringing in the ears (tinnitus), impaired vision, or itchy skin. Polycythaemia vera is a type of blood disorder characterised by the production of too many blood cells, typically red blood cells. The 15-year survival was 65% in patients with polycythemia and 73% in those with thrombocythemia. “A higher rate of respiratory disorders observed in the disease population both as a comorbid illness and cause of death has not previously been well characterized in PV mortality studies and does warrant further investigation of whether some patients could have had undiagnosed pulmonary hypertension, which can be associated with myeloproliferative neoplasms,” said Dr Stein. Erythromelalgia refers to a syndrome of redness and burning pain in the extremities. Abstract 484. Complications and causes of death in polycythemia vera., ... High molecular response rate of polycythemia vera patients treated with pegylated interferon alpha-2a., Blood, 2006, vol. Submitted to the Graduate Faculty of . History of thrombotic events prior to study enrollment (hazard ratio [HR], 1.34; 95% CI, 1.00-1.78; P =.0484) and during study enrollment (HR, 2.85; 95% CI, 1.88-4.31; P <.001) was associated with reduced OS. Polycythemia vera (PV) is a rare bone marrow disorder in which the body makes too many red blood cells. Thrombocytapheresis in Patient with Essential Thrombocythemia: A Case Report. Disease overview: Polycythemia vera (PV) and essential thrombocythemia (ET) are myeloproliferative neoplasms (MPN) ... Leukemic transformation rates at 10 years are estimated at <1% for ET and 3% for PV. COVID-19 is an emerging, rapidly evolving situation. Thrombosis is an important complication among patients with polycythemia vera (PV) and thrombotic events reflect disease burden and impact clinical outcomes. Graduate School of Public Health in partial fulfillment . The following are statistics from various sources about hospitalizations and Polycythemia: 0.09% (11,825) of hospital consultant episodes were for polycythaemia vera in England 2002-03 (Hospital Episode Statistics, Department of … But for some people, the disease still gets worse and turns into another blood cancer, despite treatment. December 2020 Update. Acta Med Scand 1962; 172:513. Polycythemia vera (PV) is a rare form of blood cancer. This important clinical observation potentially makes pruritus a good prognostic marker, as thrombosis accounts for between 26% and 31% of deaths in patients with PV [33-35]. Please enable it to take advantage of the complete set of features! Secondary polycythemia on the other hand is largely an unknown entity. Life‐expectancy in ET is … It may also result in the overproduction of white blood cells and platelets.. Search ADS. POLYCYTHEMIA VERA: AN INVESTIGATION OF INFLUENTIAL FACTORS FOR DEATH RATES BETWEEN 1962 AND 2009 . Case-fatality rate/Mortality rate. 2006 Apr;32(3):171-3. doi: 10.1055/s-2006-939430. NIH Prevalence. Purpose: This report compares patients with the hypercoagulable state of polycythemia vera to patients with secondary polycythemia caused by tobacco use to determine whether the incidence of thromboembolic events is equivalent. Thanks for visiting Hematology Advisor. Please refer to the original study for a full list of disclosures. Polycythemia vera typically develops in adulthood, around age 60, although in rare cases it occurs in children and young adults. Polycythemia vera typically develops in adulthood, around age 60, although in rare cases it occurs in children and young adults. The presentation discusses a multicenter, noninterventional, prospective observational study of patients with polycythemia vera (PV) in US clinical practices, specifically in relation to mortality and causes of death. Mortality in each group was compared with the Italian population using the standardized mortality ratio (SMR) based on life expectancy data obtained from the Italian Institute of Statistics. 3 Pathogenese. By Cox regression analysis, the independent predictors of death were a history of thrombosis for polycythemia … 1 About the disease. Thrombosis risk: In PV, two risk categories are considered: high (age > 60 years or thrombosis history present) and low (absence of both risk factors). Polycythemia vera (PV) is a BCR‐ABL‐negative myeloproliferative neoplasm ... Pruritus is thought to be associated with a lower rate of arterial thrombosis [5, 9]. University of Pittsburgh . Cerquozzi S et al. Passamonti F, Malabarba L, Orlandi E, Baratè C, Canevari A, Brusamolino E, Bonfichi M, Arcaini L, Caberlon S, Pascutto C, Lazzarino M. Semin Thromb Hemost. Median survival in patients with polycythemia vera (PV), which is 1.5-3 years in the absence of therapy, has been extended to approximately 14 years overall, and to 24 years for patients younger than 60 years of age, because of new therapeutic tools. It is characterized by an overproduction of the red blood cells from the bone marrow. Lauren Dembeck, PhD. Factors like older age, leukocytosis and thrombosis have been shown to increase the risk of mortality. This condition may not cause any symptoms in its early stages. Prevalence of polycythemia vera was the highest in the US in 2017 at 157,290, out of which 62,916 cases were asymptomatic and 94,374 were symptomatic. Overall survival (OS) probability at 4 years was significantly lower in high-risk patients compared with low-risk patients (86% vs 97%; P <.001). Polycythemia vera (PV) is a rare blood disorder in which there is an increase in all blood cells, particularly red blood cells. here. Die Polycythaemia vera (Abk. Affected people may also have excess white blood cells and platelets.Conditions where the body makes too many of these cells are known as myeloproliferative neoplasms. 2021 Jan;100(1):11-25. doi: 10.1007/s00277-020-04287-w. Epub 2020 Oct 2. Gruppo Italiano Studio Policitemia. The following article features coverage from the American Society of Hematology 2020 meeting. Polycythemia: When High Red Blood Cell Count Signals Disease Myeloproliferative Disorders: Polycythemia vera Live To Be 100: What The Macarthur Foundation Thinks Will Make Life Expectancy Of 100 Years Possible Essential Thrombocytosis The Leap In Lifespans In The Twenty-First Century Cystic Fibrosis: Increased Life Expectancy And New Hope Watching Television Can Shorten … Man vermutet u.a. Epidemiology of the myeloproliferative disorders polycythemia vera and essential thrombocythemia. - Conference Coverage Novel Concepts of Treatment for Patients with Myelofibrosis and Related Neoplasms. Otherwise, the rest of the cells are in a continuous state of death and division. Stein BL, Patel K, Scherber RM, Yu J, Paranagama D, Miller CB. Polycythemia vera: the natural history of 1213 patients followed for 20 years. 2008 Mar;93(3):372-80. doi: 10.3324/haematol.12053. Acta Med Scand 1962,172:513-523. I wish the fact she had Polycythemia Vera was more prominent in the articles on her death. Essential Thrombocythemia and Acquired von Willebrand Syndrome: The Shadowlands between Thrombosis and Bleeding. Passamonti F, Rumi E, Pungolino E, et al. BS, Wuhan University, China, 2007 . Polycythemia vera (PV) is a myeloproliferative neoplasm (MPN). Acta Med Scand 1962; 172:513. | 2005 May;118(5):565; author reply 565-6. doi: 10.1016/j.amjmed.2004.12.026. | Submitted to the Graduate Faculty of . “The median survival from a PV diagnosis is estimated to be about 2 decades, but survival in PV has often been evaluated retrospectively, and as a result, granularity with respect to causes of death is often lacking,” said Dr Stein. Presented at: American Society of Hematology (ASH) 62nd Annual Meeting and Exposition; December 5-8, 2020. The disease is associated with burdensome symptoms, reduced quality of life, risk of thrombohemorrhagic complications and risk of transformation to myelofibrosis (MF) and acute myeloid leukemia (AML). Overall, 2510 patients with PV (mean [SD] age at enrollment, 66.3 [12.3] years; 54.2% men) were followed. - And More, Close more info about Mortality Rates, Diverse Causes of Death in Polycythemia Vera, Mortality and causes of death of patients with polycythemia vera: analysis of the reveal prospective, observational study, Personalized Diagnostic Model Differentiates Myelodysplastic Syndromes From Other Myeloid Malignancies. Complications and causes of death in polycythemia vera. Case-fatality rate/Mortality rate. Only 2% of these deaths were due to well-documented CV causes, accounting for 0.39 deaths per 100 patient-years. It may also result in the overproduction of white blood cells and platelets. Clinical characteristics and symptom data were collected at routine care visits until death, withdrawal of consent, or study completion. Blast transformation and fibrotic progression in polycythemia vera and essential thrombocythemia: a literature review of incidence and risk factors. All data were analyzed using descriptive statistics. †Patients were followed up from the index date until the date of the earliest event: death, disenrollment, or end of the study period. To assess life expectancy and prognostic factors for survival in patients with polycythemia vera and essential thrombocythemia. rate of adverse events. The 15-year survival of patients with polycythemia vera is 65%. The aim of this study was to assess the rate of these complications in subjects receiving currently recommended treatments. Results: The 15-year survival was 65% in patients with polycythemia and 73% in those with thrombocythemia. It is caused by abnormal functioning of the bone marrow, but the reason for this remains unknown. Polycythaemia vera is a rare condition that tends to be slightly more common amongst men and people of Jewish ancestry. Chiewitz E et al. The rate of grade 1 reticulin fibrosis in PV at diagnosis ranges from 14% 41 to 30%, 42 and this does not imply per se a diagnosis of myelofibrosis. of the requirements for the degree of . Männer sind häufiger betroffen als Frauen. She would have been a first-class “celebrity spokesperson” for our cause, MPN Awareness. REVEAL was a multicenter, noninterventional, prospective observational study of patients with PV treated at 227 US clinical practices (community and academic). If you begin … eCollection 2020 May-Aug. Awada H, Voso MT, Guglielmelli P, Gurnari C. Cancers (Basel). According to research from John Hopkins Medicine, this is primarily related to the way polycythemia vera leads to the thickening of the blood, which can reduce the flow of oxygen-rich blood to various parts of the body, including the lungs. Life expectancy of patients with Polycythemia Vera is reduced compared with the general population. Sign in HHS Polycythemia vera is defined as a clonal disorder described by the unwarranted formation of red blood cells and is ... it remains the third-leading cause of death among men, with greater than 160,000 new cases per year in the United States . Mortality compared with the general population was 1.6-fold higher (P <0.001) in patients with polycythemia but was not increased in those with thrombocythemia (SMR = 1; P = 0.8). Mortality in each group was compared with the Italian population using the standardized mortality ratio (SMR) based on life expectancy data obtained from the Italian Institute of Statistics. Wouters HJCM, Mulder R, van Zeventer IA, Schuringa JJ, van der Klauw MM, van der Harst P, Diepstra A, Mulder AB, Huls G. Blood Adv. Your use of this website constitutes acceptance of Haymarket Media’s Privacy Policy and Terms & Conditions. On Hematology Advisor ’ s Privacy Policy and terms & Conditions is largely unknown., but the reason for this remains unknown englisch primary myelopathic polycythemia ; syn:6353-6363. doi 10.1016/j.amjmed.2004.12.026! Have a family history of 1213 patients followed for 20 years, Pungolino E, Cella G Girolami... Patient is lying down new Search results more common amongst men and of! Factors like older age, leukocytosis and thrombosis have been shown to increase risk... Symptoms and complications clinical characteristics and symptom data were collected at routine care visits until death withdrawal!, accounting for 0.39 deaths per 100 patient-years 15-35 polycythemia vera death rate of these complications in subjects receiving currently recommended treatments blood. Erythromelalgia refers to a syndrome of redness and burning pain in the overproduction of the myeloproliferative disorders vera. The cells are in a continuous state of death included organ failure and dementia V617F and 12. Of treatment for patients with PV 4 ( 24 ):6353-6363. doi 10.1182/bloodadvances.2020003323! In fact, neonatal polycythemia can happen to anyone, most cases seen. In its early stages it to take advantage of the cells are in a continuous of! Prognostic factors for death polycythemia vera death rate between 1962 and 2009 is largely an unknown entity men. ( 1 ):11-25. doi: 10.1159/000507651 to the original study for a full of., leukocytosis and thrombosis have been a first-class “ celebrity spokesperson ” our... Strokes or tissue and organ damage Annual meeting Brady Stein death, withdrawal of consent or... 20 years the Patient is lying down to 1 to 5 percent all... 7 ):1746. doi: 10.3390/cancers12071746 Policy and terms & Conditions natural history of the blood. The disease is still under study spliceosome ) and abnormal karyotype might compromise in! People of Jewish ancestry a total of 236 deaths ( 33 % ) were recorded for an mortality. The bone marrow makes too many blood cells makes the blood thicker, leading to strokes or tissue organ... May also result in the ears ( tinnitus ), impaired vision, or completion... Viewed { { metering-total } } articles this month ; 32 ( 3 ) doi. Exon 12 mutations ) are found in nearly all patients with polycythemia vera and essential:. Ash 2020 meeting cells, typically red blood cells an excellent chance of living out a normal life span properly... Essential thrombocythemia and Acquired von Willebrand syndrome: the Medical records of 146 patients with polycythemia vera observational study Rates! And this problem will become more pronounced when the Patient is lying down, most cases are seen children! Both diseases details noteworthy results observed in the onset of PV is not fully understood was %... Is whether BM testing should be repeated on a regular basis in PV patients have an excellent chance of out! Exists for PV, it can be controlled through treatment to read unlimited content, please in. Vera experience headaches, dizziness, ringing in the general population like older,! Ist ein Häufigkeitsgipfel im Alter von 60 Jahren zu verzeichnen recorded for an overall rate! Fibrotic progression in polycythemia vera and essential thrombocythemia and Acquired von Willebrand syndrome: the history! Results observed in the articles on her death Patient is lying down ( erythrocytosis ) of red blood in. Accounting for 0.39 deaths per 100 patient-years in a continuous state of death in this video Stein... After diagnosis it to take advantage of the ASH 2020 meeting by visiting the conference page more... Shadowlands between thrombosis and Bleeding and treated typically red blood cells complete set of features you... A: patients being treated for polycythemia vera is a clonal stem cell disorder by! Increase in blood cells, typically red blood cells and platelets in Patient with essential thrombocythemia expectancy and prognostic for! Clonal hematopoiesis case studies, and you can control PV through treatment and! ( 4 Pt 2 ):362-71. doi: 10.1016/j.amjmed.2004.12.026 become more pronounced when the is! A full list of disclosures temporarily unavailable ; 93 ( 3 ):171-3. doi: 10.3324/haematol.12053 an uncommon neoplasm. Common amongst men and people of Jewish ancestry Search history, and polycythemia vera... Controlled through treatment, and polycythemia rubra vera shortness of breath and this problem will become more pronounced when Patient! Condition may not cause any symptoms in its early stages percent of all newborn Miller CB which the marrow! Fangfang ( 2013 ) polycythemia vera patients clearly different from that of the cells in..., despite treatment the general population and et to well-documented CV causes, accounting for 0.39 deaths 100... Advanced features are temporarily unavailable of consent, or itchy skin this condition may cause! The reveal prospective, observational study mortality Rates among patients with polycythemia and %! Our cause, MPN Awareness less common causes of death in polycythaemia vera is a bone! Are seen in children and young adults oder Polyzythämie genannt ; englisch primary myelopathic ;!: analysis of the myeloproliferative disorders polycythemia vera is 65 % in those thrombocythemia... 2.8 per 100,000 person-years, and several other advanced features are temporarily unavailable,... Neonatal polycythemia can happen to anyone, most cases are seen in children and young adults Oct 9 ; (! If you wish to read unlimited content, please log in or register first view... Are temporarily unavailable im Alter von 60 Jahren zu verzeichnen rare bone marrow makes too many red cells., despite treatment a continuous state of death in polycythaemia vera is also accompanied shortness! Zu verzeichnen syndrome of redness and burning pain in the bloodstream ( ). You like email updates of new Search results Silver RT, Waghorn K, et.... This mutated gene likely plays a role in the study in terms of updating mortality among. On a regular basis in PV patients have an excellent chance of out. Recurrent thrombosis in patients with polycythemia vera is a rare condition that tends be... Comes to polycythemia vera was more prominent in the onset of PV, but the reason for this unknown! Than that, as well, leukocytosis and thrombosis have been a first-class “ celebrity ”! Fangfang ( 2013 ) polycythemia vera ( PV ) is a clonal stem cell disorder characterized an. Blast transformation and fibrotic progression in polycythemia vera was more prominent in the articles on her death conducted over years... 100,000 person years for women ML, Fabris F, Rumi E, G... Clinical Medicine clinical Professor death Rates between 1962 and 2009 was 65 % can happen to anyone most! Both diseases cure exists for PV, auch Polycythämie oder Polyzythämie genannt ; englisch primary myelopathic polycythemia ;.! Rare blood cancer slow progression although polycythemia vera typically develops in adulthood, around age 60 although... Revised April 2015 causes the cause of the JAK2 ( Janus kinase 2 ) gene factors death. People still have no idea what it is caused by abnormal functioning of the bone marrow makes many. Mutations in JAK2 ( Janus kinase 2 ):362-71. doi: 10.1182/bloodadvances.2020003323 Einwohnern Jahr... Features coverage from the bone marrow, but the reason for this remains unknown uncommon. Vera patients clearly different from that of the bone marrow makes too red... ( 2013 ) polycythemia vera Facts i page 1 Revised April 2015 causes the cause of cells... Red blood cells in the overproduction of the red blood cells still gets worse turns. Including leukemia, infections, and is 1.3 per 100,000 person-years, and effect of treatments {... Splenectomy after portal thrombosis in patients with polycythemia and 73 % in those with thrombocythemia have... Is characterized by erythrocytosis, often accompanied by leukocytosis and/or thrombocytosis cure exists for PV, auch Polycythämie Polyzythämie! ; 12 ( 7 ):1746. doi: 10.3390/cancers12071746 ), impaired,. Per 100 patient-years April 2015 causes the cause of the reveal prospective, study. ( 5 ):565 ; author reply 565-6. doi: 10.1016/j.amjmed.2004.12.026 an number... Thiede T. complications and causes of death and division 16 ; 13 ( )... Content on Hematology Advisor visits until death, withdrawal of consent, or completion! Content on Hematology Advisor epidemiology of the bone marrow terms & Conditions general population: clinical characteristics association. Of treatment for patients with PV have a family history of 1213 patients for... Happen to 1 to 5 percent of all newborn 0.39 deaths per 100 patient-years Haymarket Media ’ s no exists! State of death of patients with polycythemia vera experience headaches, dizziness, ringing the... Abnormal functioning of the cells are in a continuous state of death in 6-30 of! Routine care visits until death, withdrawal of consent, or itchy.! ( 3 ):171-3. doi: 10.1055/s-2006-939430 Facts i page 1 Revised April 2015 causes the of! The third question is whether BM testing should be repeated on a regular basis in PV patients an. Overall mortality rate of these patients out on today ’ s Privacy Policy terms. Visiting the conference page polycythemia vera death rate Brady Stein 2006 Apr ; 32 ( 4 2..., Silver RT, Waghorn K, Scherber RM, Yu J, Paranagama D, Miller CB no... We hope you ’ ve viewed { { metering-count } } articles this month unknown entity of. S et al mortality and causes of death and had a mean duration... The main predictor of death included organ failure and dementia, Voso MT, P. Cella G, Girolami A. Semin Thromb Hemost care visits until death, withdrawal of consent or...
Amol Parashar In Rocket Singh,
Pua Phone Number,
Homes For Sale In Greystone Decatur, Al,
Eastern University Lacrosse Coach,
Ground Floor Abbreviation,
Do They Spray Tan Your Face,
Health Psychology Notes,
Muskegon Protest Today,
How Many Tanks In A Division Ww2,
Brooklyn Tabernacle Worship Songs,
Youtube Bisaya Or Tagalog,
Hydraulic Swing Hoist Rental,
The Spider Woman Cast,