Outcomes of paroxysmal nocturnal hemoglobinuria in the pediatric age group in a resource-constrained setting

Pediatr Blood Cancer. 2020 Apr;67(4):e27712. doi: 10.1002/pbc.27712. Epub 2019 Mar 26.

Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired clonal stem cell disorder. Eculizumab and bone marrow transplantation are disease-modifying treatments for PNH but may not be readily available in resource-constrained settings. Of 52 pediatric patients with PNH, 20 had classical PNH and 32 had PNH/aplastic anemia (PNH/AA). Median time to diagnosis was 30 months in classical PNH patients. Renal failure was present in four patients (20%). Six (30%) achieved complete response, 10 (50%) achieved partial response with androgens in classical PNH. Two underwent allogenic stem cell transplantation. In the PNH/AA group, 16 (50%) were in CR and seven (21%) were in PR with anti-thymocyte globulin ± cyclosporine.

Keywords: PNH and thrombosis; androgen and steroids in PNH; pediatric PNH; renal failure in PNH.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Developing Countries
  • Female
  • Hemoglobinuria, Paroxysmal / diagnosis*
  • Hemoglobinuria, Paroxysmal / therapy*
  • Humans
  • India
  • Male
  • Retrospective Studies