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

Kota Ouchi, Shin Takahashi, Sonoko Chikamatsu, Shukuei Ito, Yoshikazu Takahashi, Sadayuki Kawai, Akira Okita, Yuki Kasahara, Yoshinari Okada, Hiroo Imai, Keigo Komine, Ken Saijo, Masahiro Takahashi, Hidekazu Shirota, Masanobu Takahashi, Makio Gamoh, Chikashi Ishioka

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)790-798
Number of pages9
JournalInternational Journal of Clinical Oncology
Volume23
Issue number4
DOIs
Publication statusPublished - 2018 Aug 1

Keywords

  • Disseminated intravascular coagulation
  • Recombinant human soluble thrombomodulin
  • Solid tumors

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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