Prolonged survival in paroxysmal nocturnal hemoglobinuria.

casional patients survive for much longer periods of time. Two of the earliest cases identified in the United States were reported from the Johns Hopkins Hospital in 1936 by Hamburger and Bernstein.13 Their paper was the first in the English language in which the disease was specifically recognized. One of their patients, a man, died of uremia in 1949, with kidneys appearing like the terminal stage of glomerulonephritis.14 Their other patient died in 1968 at the age of 60 of carcinoma of the breast. Forty-three years after the onset of PNH, she was no longer anemic, but evidence of PNH was still detectable by laboratory tests. Her longevity, and apparent “remission” of her disease, raised the question whether all patients who survive for more than 20 years also exhibit apparent “cure” of PNH.