Key Features of the Paper
STUDY AIM
To study the safety and efficacy of recombinant soluble thrombomodulin (rTM) in treatment of disseminated intravascular coagulation (DIC) complicating acute leukemia.
Methods
A multicenter prospective study was performed to examine outcomes of rTM treatment for DIC in patients with acute leukemia.
Results
Of 33 patients registered in this study, 13 had acute myeloid leukemia (AML), three had acute lymphoblastic leukemia (ALL), and 17 had acute promyelocytic leukemia (APL). The cumulative rates of DIC resolution at day 7 and day 35 were 56 and 81% in AML/ALL and 53 and 77% in APL, respectively. The median time from the initiation of rTM to DIC resolution was 4 days in AML/ALL and 6 days in APL patients. Adverse events related to hemorrhage occurred in two AML/ALL patients (13%) and three APL patients (18%). Of these, one AML/ALL patient died with intracranial hemorrhage, and two APL patients died with intracranial hemorrhage and pulmonary hemorrhage.
Conclusion
These results suggest that recombinant soluble thrombomodulin (rTM) may improve the survival of acute leukemia patients with disseminated intravascular coagulation (DIC) by inhibiting early death related to hemorrhagic events, as reported previously.