{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:48:30Z","timestamp":1787161710943,"version":"build-2736575974"},"reference-count":109,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alexion, AstraZeneca Rare Disease"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Thromboembolism (TE) is a major cause of morbidity and mortality in patients with paroxysmal nocturnal hemoglobinuria (PNH). This narrative review summarizes available evidence on TE in Asian patients with PNH and discusses practical considerations and challenges for preventing and managing PNH-associated TE in Asian populations. Evidence suggests that, compared with non-Asians, fewer Asian patients have a history of TE (3.6% vs. 8.9%, p &lt; 0.01), receive anticoagulants (8.5% vs. 16.2%, p = 0.002), or die from TE (6.9% vs. 43.7%, p = 0.000). Independent predictors of TE include lactate dehydrogenase \u2265 1.5 \u00d7 upper limit of normal, pain, and male sex. Clone size alone does not appear to be a reliable estimate of TE risk. D-dimer levels are a useful marker of hemostatic activation, although they are not specific to PNH. Complement inhibition reduces the incidence of TE, although it does not wholly eliminate TE risk. Eligibility criteria and access to complement inhibitors vary across Asia, with limited availability in some countries. Anticoagulation is required to treat acute TE events and for primary or secondary prophylaxis in selected patients. Physicians and patients must stay alert to the signs and symptoms of TE to ensure prompt and appropriate treatment.<\/jats:p>","DOI":"10.3390\/ijms26062504","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T06:52:30Z","timestamp":1741675950000},"page":"2504","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevention and Management of Thromboembolism in Patients with Paroxysmal Nocturnal Hemoglobinuria in Asia: A Narrative Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1562-1013","authenticated-orcid":false,"given":"Yasutaka","family":"Ueda","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine, Faculty of Medicine, Osaka University, 1-1 Yamadaoka, Suita 565-0871, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2967-698X","authenticated-orcid":false,"given":"Wen-Chien","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung Shan S. Rd. (Zhongshan S. Rd.), Zhongzheng, Taipei City 100225, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7069-0997","authenticated-orcid":false,"given":"Yeow-Tee","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Outram Rd., Singapore 169608, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7912-1996","authenticated-orcid":false,"given":"Ponlapat","family":"Rojnuckarin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama IV Rd., Pathum Wan, Bangkok 10330, Thailand"},{"name":"Excellence Center in Translational Hematology, Chulalongkorn University, 1873 Rama IV Rd., Pathumwan, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8986-8436","authenticated-orcid":false,"given":"Jin Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, 50-1 Yonsei-ro, Sinchon-dong, Seodaemun-gu, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9011-4268","authenticated-orcid":false,"given":"Raymond Siu Ming","family":"Wong","sequence":"additional","affiliation":[{"name":"Sir Y.K. Pao Centre for Cancer and Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Sha Tin, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily Lee","family":"Lee Wong","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, 13a, Jalan Penampang, Kota Kinabalu 88200, Sabah, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7423-4676","authenticated-orcid":false,"given":"Jun Ho","family":"Jang","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Suwon 16419, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0495-3859","authenticated-orcid":false,"given":"Tzeon-Jye","family":"Chiou","sequence":"additional","affiliation":[{"name":"Cancer Center, Division of Hematology and Oncology, Department of Medicine, Taipei Municipal Wanfang Hospital, Taipei Medical University, No. 111, Section 3, Xinglong Rd., Wenshan District, Taipei City 11696, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzuru","family":"Kanakura","sequence":"additional","affiliation":[{"name":"Department of Hematology, Sumitomo Hospital, 5-ch\u014dme-3-20 Nakanoshima, Kita Ward, Osaka 530-0005, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2949-4166","authenticated-orcid":false,"given":"Jong Wook","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Hanyang University Seoul Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4985","DOI":"10.1182\/blood-2012-09-311381","article-title":"Thrombosis in paroxysmal nocturnal hemoglobinuria","volume":"121","author":"Hill","year":"2013","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/j.1538-7836.2007.02379.x","article-title":"Thrombosis in paroxysmal nocturnal hemoglobinuria: Sites, risks, outcome. 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