A patient with paroxysmal nocturnal hemoglobinuria (PNH) may be at increased risk for thrombosis. Certain findings can help to identify a patient who may benefit from prophylaxis to prevent thrombosis. The authors are from Leeds General Infirmary.


Patient selection: PNH


Indicators for prophylaxis:

(1) granulocyte clone > 50%

(2) platelet count stable AND > 100,000 per µL


Additional considerations may include (not in paper):

(1) history of thrombosis

(2) other risk factors for hypercoagulability


Considerations when selecting prophylactic regimen:

(1) contraindications for a particular agent

(2) need to adjust therapy over time based on changing risk of thrombosis and anticoagulant bleeding


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