Li L Y, Fu R
Department of Hematology, General Hospital, Tianjin Medical University, Tianjin Key Laboratory of Bone Marrow Failure and Malignant Hemopoietic Clone Control, Tianjin Institute of Hematology, Tianjin 300052, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Dec 14;45(12):1071-1077. doi: 10.3760/cma.j.issn.0253-2727.2024.12.101.
Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal disorder of hematopoietic stem cells induced by PIG-A gene mutations. It is clinically manifested by hemolysis, bone marrow failure, and high-risk concurrent thrombosis, which are life-threatening in severe cases. Significant progress has been made in the pathogenesis research and clinical diagnosis and treatment of PNH in recent years. The Red Blood Cell Disease (Anemia) Group Chinese Society of Hematology, Chinese Medical Association, combined with the latest diagnosis and treatment progress of PNH, relevant foreign guidelines/consensus, and China's national conditions, jointly formulated the "Guidelines for the diagnosis and management of paroxysmal nocturnal hemoglobinuria (2024) " based on extensive solicitation of expert suggestions and opinions. This article discussed the key and difficult issues in PNH diagnosis and treatment, interpreted the updated part of the guidelines, and expanded the relevant recommendations of the guidelines according to the latest research progress at home and abroad, thereby providing more references for clinical practice.
阵发性睡眠性血红蛋白尿(PNH)是一种由PIG-A基因突变引起的获得性造血干细胞克隆性疾病。临床上表现为溶血、骨髓衰竭以及高风险的并发血栓形成,严重时可危及生命。近年来,PNH的发病机制研究以及临床诊断和治疗取得了显著进展。中华医学会血液学分会红细胞疾病(贫血)学组结合PNH最新的诊断和治疗进展、国外相关指南/共识以及我国国情,在广泛征求专家意见的基础上,共同制定了《阵发性睡眠性血红蛋白尿诊断和治疗指南(2024年版)》。本文探讨了PNH诊断和治疗中的关键和难点问题,解读了指南的更新部分,并根据国内外最新研究进展对指南的相关推荐进行了扩展,从而为临床实践提供更多参考。