Disseminated Intravascular Coagulation: Laboratory Support for Management and Treatment

Disseminated intravascular coagulation (DIC) is a condition in which hemostasis is altered, resulting in unregulated activation of the coagulation cascade. The hallmarks of DIC are thrombosis (from excess clotting), bleeding (from consumption of the coagulation proteins), and thrombocytopenia and anemia (from mechanical destruction of red cells and platelets by coagulation in the microvasculature). DIC is not an isolated disease, it is a symptom of another illness such as endothelial trauma, sepsis, malignancy, or a complication of pregnancy. Therefore, treatment of the underlying medical condition and supportive care with blood products is the mainstay of therapy for DIC. Measurement of platelet count, prothrombin time/activated partial thromboplastin time (PT/aPTT), fibrinogen, and D-dimer, can help diagnose DIC, but treating with blood components only to correct abnormal laboratory tests may not be efficacious. Replenishing coagulation factors, platelets, and red cells should be attempted cautiously as dictated by the clinical scenario. In this report, we discuss the role of the blood bank in helping to manage DIC in hematologic malignancy.