Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors

被引：16

作者：

Ouchi, Kota ^{[1
,2
]}

Takahashi, Shin ^{[1
,2
]}

Chikamatsu, Sonoko ^{[1
,2
]}

Ito, Shukuei ^{[1
,2
]}

Takahashi, Yoshikazu ^{[3
]}

Kawai, Sadayuki ^{[3
]}

Okita, Akira ^{[1
,2
]}

Kasahara, Yuki ^{[1
,2
]}

Okada, Yoshinari ^{[1
,2
]}

Imai, Hiroo ^{[1
,2
]}

Komine, Keigo ^{[1
,2
]}

Saijo, Ken ^{[1
,2
]}

Takahashi, Masahiro ^{[1
,2
]}

Shirota, Hidekazu ^{[1
,2
]}

Takahashi, Masanobu ^{[1
,2
]}

Gamoh, Makio ^{[3
]}

Ishioka, Chikashi ^{[1
,2
]}

机构：

[1] Tohoku Univ Hosp, Dept Med Oncol, Sendai, Miyagi, Japan

[2] Tohoku Univ, Inst Dev Aging & Canc, Dept Clin Oncol, Aoba Ku, 4-1 Seiryo Machi, Sendai, Miyagi 9808575, Japan

[3] Osaki Citizen Hosp, Dept Med Oncol, Osaki, Japan

来源：

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY | 2018年 / 23卷 / 04期

关键词：

Disseminated intravascular coagulation; Recombinant human soluble thrombomodulin; Solid tumors; CANCER-PATIENTS; ACTIVATION; TRIAL; TREAT;

D O I：

10.1007/s10147-018-1261-z

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Recombinant human soluble thrombomodulin (rTM) has been established and introduced in the clinic as a standard treatment for disseminated intravascular coagulation (DIC). However, the efficacy and safety of rTM for DIC associated with solid tumors (DIC-STs) have not been fully established. Here, we performed a retrospective analysis of the clinical outcomes of rTM for DIC-STs and considered a treatment strategy with rTM for DIC-STs. Patients with DIC-STs between November 2009 and March 2016 in 2 cancer core hospitals were retrospectively analyzed. Data, including patient background, treatment course, and clinical outcomes of rTM for DIC-STs, were extracted. The clinical outcomes were evaluated by comparing the DIC score, resolution rate, and overall survival (OS) duration. The study included 123 patients with DIC-STs. The median OS in all patients was 41 days. The DIC resolution rate was 35.2%. DIC scores and DIC-related blood test data (fibrin degradation product and prothrombin time-international normalized ratio) significantly improved at the end of rTM administration (P < 0.001). The OS duration was longer in patients who were treated with chemotherapy after DIC onset than in those who were not treated with chemotherapy (median, 178 days vs. 17 days, P < 0.001). In both univariate and multivariate analyses, chemotherapy after DIC onset showed the strongest association with OS. rTM can at least temporarily improve or maintain the state of DIC-STs. It is suggested that prolongation of survival can be expected when control of DIC and treatment of the underlying disease are compatible.

引用

页码：790 / 798

页数：9

共 16 条

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