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논문 기본 정보

자료유형
학술저널
저자정보
Jang Jun Ho (Division of Hemato-oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.) Kim Jin Seok (Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.) Lim Cindy Thiow Koon (IQVIA Solutions Asia Pte Ltd., Singapore.) Kleinman Nora J. (IQVIA Solutions Hong Kong Ltd., Hong Kong SAR.) Myren Karl-Johan (Alexion, AstraZeneca Rare Disease, Boston, MA, USA.) Wang Alice (Alexion, AstraZeneca Rare Disease, Boston, MA, USA.) Patel Yogesh (Alexion, AstraZeneca Rare Disease, Boston, MA, USA.) Lee Jong Wook (Division of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.39 No.8
발행연도
2024.3
수록면
1 - 10 (10page)
DOI
10.3346/jkms.2024.39.e81

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Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disorder caused by uncontrolled terminal complement activation, which leads to intravascular hemolysis (IVH), thromboembolism (TE), renal failure, and premature mortality. Methods: We performed a secondary analysis of data collected from patients enrolled in the Korean National PNH Registry to assess the relative importance of risk factors, specifically lactate dehydrogenase (LDH) and hemoglobin (Hb), in predicting the incidence of TE, impaired renal function, and death in complement inhibitor-naïve patients with PNH. Results: Multivariate regression modeling indicated that LDH ≥ 1.5 × upper limit of normal (ULN), male sex, and pain were associated with increased risk of TE (P = 0.016, 0.045, and 0.033, respectively), hemoglobinuria and pain were associated with an increased risk of impaired renal function (P = 0.034 and 0.022, respectively), and TE was associated with an increased incidence of death (P < 0.001). Hb < 8 g/dL was not a predictor of TE, impaired renal function, or death in multivariate regression analyses. Standardized mortality ratio analysis indicated that LDH ≥ 1.5 × ULN (P < 0.001), Hb < 8 g/dL (P < 0.001), and Hb ≥ 8 g/dL (P = 0.004) were all risk factors for death; in contrast, patients with LDH < 1.5 × ULN had similar mortality to the general population. Conclusion: In complement inhibitor-naïve patients with PNH, LDH ≥ 1.5 × ULN was a significant predictor of TE, and TE was a significant predictor of death. Hb was not a significant predictor of TE, impaired renal function, or death. Therefore, controlling IVH will improve clinical outcomes for patients with PNH.

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