The Effect of Respiratory Viral Infections on Breakthrough Hemolysis in Patients with Paroxysmal Nocturnal Hemoglobinuria
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristics
2.2. Infection Parameters
2.3. Hemolytic Parameters
3. Discussion
4. Materials and Methods
Statistical Analysis
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | NTS+ | NTS− | p-Value |
---|---|---|---|
Number of patients | 11 | 23 | |
Age, years (median) | 49.5 | 51 | |
Sex | |||
Male | 7 | 6 | |
Female | 4 | 17 | |
Classification of PNH | |||
Classical | 7 | 19 | |
Associated with other BM disorder | 4 | 4 | |
Indication for Eculizumab Rx | |||
Hemolysis | 7 | 22 | |
Thrombosis | 3 | 0 | |
Other (pregnancy) | 1 | 1 | |
Eculizumab duration of Rx months, mean (SEM) | 83.1 (16.78) | 52.7 (6.28) | 0.0007 |
Antibiotic prophylaxis | |||
Yes | 10 | 20 | |
No | 1 | 3 | |
On Cyclosporin | |||
No | 11 | 21 | |
Yes | 0 | 2 | |
Transfusion Dependent | 0.07 | ||
Yes | 5 | 4 | |
No | 6 | 19 |
Characteristics | NTS+ | NTS− | p-Value |
---|---|---|---|
CRP rise | |||
Yes | 6 | 8 | |
No | 5 | 15 | |
Percentage increase in CRP (mean, SEM) | 34.5 (9.7) | 12.2 (3.4) | 0.04 |
WCC rise | |||
Yes | 8 | 6 | |
No | 3 * | 17 | |
Percentage increase in WCC (mean, SEM) | 33.8 (7.1) | 11.1 (4.7) | 0.01 |
Neutrophil rise | 8 | 6 | |
Percentage increase in neutrophil count (mean, SEM) | 42.8 (14.1) | 12.7 (5.5) | 0.04 |
Neutrophil drop | 3 | 8 | |
Percentage drop in neutrophil count (mean, SEM) | 39.07 (24.37) | 20.05 (3.06) | 0.22 |
Hospitalization | |||
Yes | 3 | 2 | |
No | 8 | 21 | |
Need for Antibiotics | |||
Yes | 6 | 5 | |
No | 5 | 18 | |
Need for Oseltamivir | |||
Yes | 4 | 0 | |
No | 7 | 23 | |
Need for GCSF | |||
Yes | 1 | 0 | |
No | 10 | 23 |
Characteristic | NTS+ | NTS− | p-Value |
---|---|---|---|
LDH increase | |||
Yes | 7 | 13 | |
No | 4 | 10 | |
Percentage increase in LDH (mean, SEM) | 87.9 (28.4) | 51.6 (14.5) | 0.2 |
Bilirubin | |||
Yes | 6 | 2 | |
No | 5 | 21 | |
Percentage increase in bilirubin (mean, SEM) | 66.2 (13.7) | 22.6 (3.0) | 0.02 |
Hemoglobin drop | |||
Yes | 8 | 8 | |
No | 3 | 15 | |
Percentage drop in hemoglobin (mean, SEM) | 25.4 (4.5) | 4.7 (1.6) | 0.002 |
Need for RBC transfusion | |||
Yes | 3 | 0 | |
No | 8 | 23 | |
Extra eculizumab dose | |||
Yes | 2 | 0 | |
No | 9 | 23 | |
Time from last eculizumab dose (days) at NPA testing (mean, SEM) | 11.2 (5.2) | 2.8 (1.2) | 0.53 |
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Lazana, I.; Apap Mangion, S.; Babiker, S.; Large, J.; Trikha, R.; Zuckerman, M.; Gandhi, S.; Kulasekararaj, A.G. The Effect of Respiratory Viral Infections on Breakthrough Hemolysis in Patients with Paroxysmal Nocturnal Hemoglobinuria. Int. J. Mol. Sci. 2023, 24, 9358. https://doi.org/10.3390/ijms24119358
Lazana I, Apap Mangion S, Babiker S, Large J, Trikha R, Zuckerman M, Gandhi S, Kulasekararaj AG. The Effect of Respiratory Viral Infections on Breakthrough Hemolysis in Patients with Paroxysmal Nocturnal Hemoglobinuria. International Journal of Molecular Sciences. 2023; 24(11):9358. https://doi.org/10.3390/ijms24119358
Chicago/Turabian StyleLazana, Ioanna, Sean Apap Mangion, Selma Babiker, Joanna Large, Roochi Trikha, Mark Zuckerman, Shreyans Gandhi, and Austin G. Kulasekararaj. 2023. "The Effect of Respiratory Viral Infections on Breakthrough Hemolysis in Patients with Paroxysmal Nocturnal Hemoglobinuria" International Journal of Molecular Sciences 24, no. 11: 9358. https://doi.org/10.3390/ijms24119358