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阵发性睡眠性血红蛋白尿症孕妇的依库珠单抗治疗:波兰经验。

Eculizumab treatment in pregnant women with paroxysmal nocturnal hemoglobinuria: A Polish experience.

机构信息

Clinic of Hematology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.

Clinic of Hematology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Poland.

出版信息

Adv Clin Exp Med. 2022 Jun;31(6):707-710. doi: 10.17219/acem/150600.

Abstract

BACKGROUND

Eculizumab is an antibody targeting the C5 complement protein. Clinical trials suggest that eculizumab significantly reduces transfusion requirements and prevents disease complications in patients with paroxysmal nocturnal hemoglobinuria (PNH).

OBJECTIVES

To analyze the outcome of pregnancies among Polish women with PNH treated with eculizumab as a part of the Polish National Health Fund program.

MATERIAL AND METHODS

We report the outcomes of 3 pregnancies among women treated with eculizumab between 2017 and 2020. For 1 of these woman, it was the 1st pregnancy, while the remaining 2 patients had previously had 1 previous successful pregnancy each.

RESULTS

All 3 mothers survived pregnancy, and all children were born alive. One of the patients had a vaginal delivery. Another required cesarean delivery at the 34th week due to a decreasing platelet count. In 1 case, premature rupture of the fetal membranes occurred at week 36, followed by artificial labor induction. All children were born without any inborn defects. The 2 prematurely born babies required a prolonged hospital stay.

CONCLUSION

Treatment with eculizumab seems to reduce the risk to a mother and a child associated with PNH. However, more data are necessary to confirm this notion.

摘要

背景

依库珠单抗是一种针对 C5 补体蛋白的抗体。临床试验表明,依库珠单抗可显著降低阵发性睡眠性血红蛋白尿症(PNH)患者的输血需求并预防疾病并发症。

目的

分析波兰国家健康基金计划中接受依库珠单抗治疗的 PNH 女性的妊娠结局。

材料与方法

我们报告了 3 名在 2017 年至 2020 年间接受依库珠单抗治疗的女性的妊娠结局。其中 1 名女性是首次妊娠,而其余 2 名患者此前各有 1 次成功妊娠。

结果

所有 3 位母亲均在妊娠期间存活,所有孩子均为活产。1 名患者经阴道分娩,另 1 名患者因血小板计数下降在第 34 周行剖宫产。1 例患者在第 36 周发生胎膜早破,随后行人工引产。所有儿童均无先天性缺陷。2 名早产儿需要长时间住院治疗。

结论

依库珠单抗治疗似乎降低了 PNH 相关的母婴风险。然而,需要更多数据来证实这一观点。

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