title: [The efficacy of early use of recombinant soluble thrombomodulin for disseminated intravascular coagulation complicated with hematologic malignancies].
abstract: We retrospectively investigated treatment outcomes with soluble recombinant thrombomodulin (rTM) for disseminated intravascular coagulation (DIC) associated with hematological malignancies (acute leukemia and malignant lymphoma) at our hospital. After rTM administration, DIC scores improved in 29 of 39 cases with hematological malignancies (74.36%). Although one case with recurrent and refractory APL died due to cerebral bleeding during rTM administration, no bleeding-associated adverse events were observed in the other 38 cases. DIC improvement was augmented in cases with acute leukemia when rTM was introduced in the pre-DIC state. CRP decreased in 26 of 36 cases with hematological malignancies (72.22%) after rTM introduction, and CRP decreased particularly significantly in cases with malignant lymphoma, suggesting rTM to exert anti-inflammatory activity. Taken together, these observations indicate that rTM, which rarely causes bleeding-associated adverse events, is an excellent agent in terms of both efficacy and safety for treating DIC associated with hematological malignancies, and the potential anti-inflammatory activity of this agent was also suggested.
authors.affiliation: Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
authors.forename: Makoto
authors.initials: M
authors.lastname: Usami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Saori
authors.initials: S
authors.lastname: Shimoyama
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kanari
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Fujii
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy* / Q000209:etiology; D061345:Early Medical Intervention; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012995:Solubility; D018180:Thrombomodulin / Q000737:chemistry / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D018180:Thrombomodulin