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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Japan 2018
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.
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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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