Recombinant activated factor VII in patients with cancer and hemorrhagic disseminated intravascular coagulation.
The use of rFVIIa in conditions associated with disseminated intravascular coagulation (DIC) has always been an area of concern in view of the theoretical possibility of enhancing thrombotic complications. However, there have been
many anecdotal reports of its efficacy and safety in DIC associated with
hemorrhagic states such as obstetric surgeries and snake bites. This paper reports effectiveness of rFVIIa in controlling hemorrhagic manifestations in 15 of 18 patients with malignancy associated with DIC. The patients did not respond to prior support with blood products with or without specific
chemotherapy. No thromboembolic complications were reported. It was observed that treatment was associated with shortening of PT and APTT and increase in fibrinogen level in the responding patients, but the D-diamer levels
remained elevated. This report opens the possibility for using rFVIIa in a new type of patients, but this approach remains experimental and should be viewed with extreme caution.
– Maadh Aldouri