Successful Treatment of Disseminated Intravascular Coagulation by Recombinant Human Soluble Thrombomodulin in Patients with Acute Myeloid Leukemia

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Nov 2

PMID 30383650

Citations 9

Authors

Miyuki Ookura

Naoko Hosono

Toshiki Tasaki

Kana Oiwa

Kei Fujita

Kazuhiro Ito

Shin Lee

Yasufumi Matsuda

Mihoko Morita

Katsunori Tai

Eiju Negoro

Shinji Kishi

Hiromichi Iwasaki

Takanori Ueda

Takahiro Yamauchi

Affiliations

Soon will be listed here.

Abstract

Disseminated intravascular coagulation (DIC) is a life-threatening condition that frequently occurs in patients with hematologic malignancies. Currently, recombinant human soluble thrombomodulin (rTM) is a therapeutic DIC drug that is manufactured and sold in Japan only. We evaluated the efficacy of rTM compared to that of gabexate mesilate (GM), which was previously used routinely for treating DIC in Japan, in patients with acute myeloid leukemia (AML). This retrospective study enrolled 43 AML patients, including 17 with acute promyelocytic leukemia (APL), that was complicated with DIC. DIC resolution rates in non-APL AML and rTM-treated APL patients were 68.4% and 81.8%, respectively. In non-APL AML patients, the duration of rTM administration was significantly shorter than that of GM (7 vs 11 days), suggesting that rTM could improve DIC earlier than GM, although rTM was used in patients with more severe DIC. Moreover, treatment with rTM significantly improved DIC score, fibrinogen, fibrin/fibrinogen degradation product (FDP), and prothrombin time (PT) ratio. Conversely, treatment with GM only improved the DIC score and FDP. In APL patients, the duration of rTM administration was also significantly shorter than that of GM. No severe side effects associated with the progression of bleeding were observed during rTM administration. These findings suggest that rTM is safe, and its anti-DIC effects are more prompt than GM for treating AML patients with DIC.

Citing Articles

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Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 2: hematologic malignancy.

Kawano N, Ikezoe T, Seki Y, Yamakawa K, Okamoto K, Fukatsu M Int J Hematol. 2024; .

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PMID: 38304177 PMC: 10831402. DOI: 10.3892/ol.2024.14246.

A systematic review and meta-analysis of recombinant human soluble thrombomodulin for the treatment of DIC associated with hematological malignancies.

Kawano N, Fukatsu M, Yamakawa K, Seki Y, Wada H, Okamoto K Int J Hematol. 2024; 119(4):416-425.

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Yamamoto A, Ito T, Hifumi T Toxins (Basel). 2022; 14(5).

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