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Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors
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 establishe...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Japan
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097084/ https://www.ncbi.nlm.nih.gov/pubmed/29511940 http://dx.doi.org/10.1007/s10147-018-1261-z |
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author | Ouchi, Kota Takahashi, Shin Chikamatsu, Sonoko Ito, Shukuei Takahashi, Yoshikazu Kawai, Sadayuki Okita, Akira Kasahara, Yuki Okada, Yoshinari Imai, Hiroo Komine, Keigo Saijo, Ken Takahashi, Masahiro Shirota, Hidekazu Takahashi, Masanobu Gamoh, Makio Ishioka, Chikashi |
author_facet | Ouchi, Kota Takahashi, Shin Chikamatsu, Sonoko Ito, Shukuei Takahashi, Yoshikazu Kawai, Sadayuki Okita, Akira Kasahara, Yuki Okada, Yoshinari Imai, Hiroo Komine, Keigo Saijo, Ken Takahashi, Masahiro Shirota, Hidekazu Takahashi, Masanobu Gamoh, Makio Ishioka, Chikashi |
author_sort | Ouchi, Kota |
collection | PubMed |
description | 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10147-018-1261-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6097084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer Japan |
record_format | MEDLINE/PubMed |
spelling | pubmed-60970842018-08-24 Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors Ouchi, Kota Takahashi, Shin Chikamatsu, Sonoko Ito, Shukuei Takahashi, Yoshikazu Kawai, Sadayuki Okita, Akira Kasahara, Yuki Okada, Yoshinari Imai, Hiroo Komine, Keigo Saijo, Ken Takahashi, Masahiro Shirota, Hidekazu Takahashi, Masanobu Gamoh, Makio Ishioka, Chikashi Int J Clin Oncol Original Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10147-018-1261-z) contains supplementary material, which is available to authorized users. Springer Japan 2018-03-07 2018 /pmc/articles/PMC6097084/ /pubmed/29511940 http://dx.doi.org/10.1007/s10147-018-1261-z Text en © Japan Society of Clinical Oncology 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Ouchi, Kota Takahashi, Shin Chikamatsu, Sonoko Ito, Shukuei Takahashi, Yoshikazu Kawai, Sadayuki Okita, Akira Kasahara, Yuki Okada, Yoshinari Imai, Hiroo Komine, Keigo Saijo, Ken Takahashi, Masahiro Shirota, Hidekazu Takahashi, Masanobu Gamoh, Makio Ishioka, Chikashi Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
title | Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
title_full | Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
title_fullStr | Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
title_full_unstemmed | Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
title_short | Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
title_sort | retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097084/ https://www.ncbi.nlm.nih.gov/pubmed/29511940 http://dx.doi.org/10.1007/s10147-018-1261-z |
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