Recombinant human soluble thrombomodulin safely and effectively rescues acute promyelocytic leukemia patients from disseminated intravascular coagulation.
We treated individuals for disseminated intravascular coagulation (DIC) caused by acute promyelocytic leukemia (APL) (n=9) using human soluble thrombomodulin (rTM) in combination with all-trans retinoic acid (ATRA) and chemotherapy, and compared the clinical outcomes with historical control patients (n=8) treated with ATRA and/or chemotherapy. Two control patients developed intracranial vascular incidents. On the other hand, no bleeding related mortality was noted in rTM-treated patients. Notably, treatment with rTM rescued patients from DIC earlier than historical controls (log rank test, p=0.019). These results suggest that administration of rTM should be considered for the treatment of individuals with DIC associated with APL.
Department of Hematology and Respiratory Medicine, Kochi University, Nankoku, Kochi, Japan. ikezoet@kochi-u.ac.jp
Takayuki
T
Ikezoe
Asako
A
Takeuchi
Mayuka
M
Isaka
Yu
Y
Arakawa
Naomi
N
Iwabu
Tsukie
T
Kin
Kazuki
K
Anabuki
Mizu
M
Sakai
Ayuko
A
Taniguchi
Kazuto
K
Togitani
Akihito
A
Yokoyama
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D018180:Thrombomodulin / Q000627:therapeutic use*; D014212:Tretinoin / Q000008:administration & dosage
D011994:Recombinant Proteins; C546931:THBD protein, human; D018180:Thrombomodulin; D003561:Cytarabine; D014212:Tretinoin