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Hematology

Study identifies key risk factors for thromboembolic events in patients with PNH

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An analysis conducted on patients with paroxysmal nocturnal hemoglobinuria (PNH) who were not treated with C5 inhibitors has identified key risk factors for thromboembolic events (TE).

These factors include a history of TE, a high percentage of GPI-negative granulocytes (≥ 30%), and a lactate dehydrogenase (LDH) ratio ≥ 1.5 times the upper limit of normal (ULN) combined with ≥ 2 high disease activity (HDA) criteria.

The research, based on data from the International PNH Registry, included 2541 eligible patients. Among them, 57 with a history of at least 1 TE were closely examined and matched with 189 control patients without any TE history.

The findings revealed that patients with no previous TE history, who were concurrently under recent anticoagulation, exhibited a notably higher thrombotic risk with an odds ratio of 9.30 (95% CI: 1.20-72.27). Similarly, patients with a history of TE demonstrated an elevated risk, particularly when recent anticoagulation was involved. For those without recent anticoagulation, the odds ratio remained substantial at 5.33.

Patients with a GPI-negative granulocyte percentage of ≥ 30% but < 50% showed an odds ratio of 4.94, while those with ≥ 50% exhibited an odds ratio of 1.97. Patients with a lactate dehydrogenase ratio ≥ 1.5 times the upper limit of normal combined with ≥ 2 HDA criteria also exhibited an increased risk, with odds ratios ranging from 3.18 for 2-3 criteria, to 3.60 for ≥ 4 criteria.

Reference
Höchsmann B, Peffault de Latour R, Hill A, et al. Risk factors for thromboembolic events in patients with paroxysmal nocturnal hemoglobinuria (PNH): a nested case-control study in the International PNH Registry. Ann Hematol. 2023;doi: 10.1007/s00277-023-05402-3. Epub ahead of print. PMID: 37668788.

 

 

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