title: [Clinical efficacy of recombinant activated factor Ⅶ a for 16 hematonosis with moderate or severe bleeding].
abstract: Objective:To analyze the efficacy of recombinant activated factor Ⅶ a (rF Ⅶ a) on hematonosis with moderate or severe bleeding signs.Methods:Of total 16 cases with rF Ⅶ a treatment from May 2013 to May 2016, 8 cases received allogeneic hematopoietic stem cells transplantation (allo-HSCT) and the other were non-transplantation patients. In two groups, there was no significant difference on rF Ⅶ a usage and dosage. 15 patients with acute graft-versus-host disease (aGVHD) after allo-HSCT were control group (without rF Ⅶ a) .Results:①The total response rate was 75.0% (6/8) in non-transplantation group and 37.5% (3/8) in transplantation group, respectively. Median interval for hemorrhage stop was 38.5 hours in non-transplantation group and 63.0 hours in transplantation group. The median overall survival (OS) was 201.0 and 29.0 days for non-transplantation group and transplantation group, respectively, and the OS rate was 50.0% (4/8) and 25.0% (2/8) , respectively. The bleeding-related mortality rate was 50.0% (2/4) and 83.3% (5/6) , respectively. ②Of the 16 cases, 9 showed response to rF Ⅶ a treatment and the other 7 cases'bleeding signs did not alleviate. The median OS was 268.0 in 9 cases with response and 24.0 days in 7 cases without response, respectively. ③In patients with intestinal aGVHD complicated with intestinal hemorrhage, the median OS of observation group (n=6) and control group (n=15) were 25.5 days and 20.0 days, respectively.Conclusion:Patients with hematological diseases, especially patients after allo-HSCT, had high bleeding-related mortality, and rFⅦa therapy had a obvious hemostatic efficacy. The survival rate of patients with response was higher than that of cases without response. The causes of poor hemostasis efficacy of rF Ⅶ a therapy were associated with unsatisfactory control of complications in patients with intestinal bleeding after allo-HSCT.
authors.affiliation: Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital to Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: F
authors.initials: F
authors.lastname: Yang
authors.forename: L J
authors.initials: LJ
authors.lastname: Kong
authors.forename: J W
authors.initials: JW
authors.lastname: Hu
authors.forename: N
authors.initials: N
authors.lastname: Liu
authors.forename: Y F
authors.initials: YF
authors.lastname: Su
authors.forename: Y H
authors.initials: YH
authors.lastname: Li
authors.forename: J L
authors.initials: JL
authors.lastname: Chen
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Yu
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Qiao
authors.forename: Q H
authors.initials: QH
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Jiang
mesh_terms: D015942:Factor VIIa; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006470:Hemorrhage; D006801:Humans; D011994:Recombinant Proteins; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: Allogeneic hematopoietic stem cell transplantation; Factor Ⅶa,recombinant; Hematologic Diseases; Hemorrhage