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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