Management of cancer-associated disseminated intravascular coagulation

Cancer may be complicated by the occurrence of disseminated intravascular coagulation (DIC). DIC is characterized by a widespread and intravascular activation of coagulation (leading to intravascular fibrin deposition) and simultaneous consumption of coagulation factors and platelets (potentially re...

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Veröffentlicht in:Thrombosis research Jg. 140; S. S66 - S70
1. Verfasser: Levi, Marcel
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Ltd 01.04.2016
Schlagworte:
Anticoagulants - therapeutic use
Blood Coagulation - drug effects
Cancer
Coagulation
Disease Management
Disseminated intravascular coagulation
Disseminated Intravascular Coagulation - blood
Disseminated Intravascular Coagulation - complications
Disseminated Intravascular Coagulation - drug therapy
Disseminated Intravascular Coagulation - pathology
Fibrinolysis
Hematology, Oncology and Palliative Medicine
Humans
Neoplasms - blood
Neoplasms - complications
Neoplasms - pathology
Thrombotic Microangiopathies - blood
Thrombotic Microangiopathies - complications
Thrombotic Microangiopathies - pathology
Thrombotic microangiopathy
Tissue factor
Thrombotic microangiopathy
Disseminated intravascular coagulation
Fibrinolysis
Tissue factor
Coagulation
Cancer
ISSN:0049-3848, 1879-2472, 1879-2472
Online-Zugang:Volltext
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Zusammenfassung:Cancer may be complicated by the occurrence of disseminated intravascular coagulation (DIC). DIC is characterized by a widespread and intravascular activation of coagulation (leading to intravascular fibrin deposition) and simultaneous consumption of coagulation factors and platelets (potentially resulting in bleeding). Clinically, DIC in cancer has in general a less fulminant presentation than the types of DIC complicating sepsis and trauma. A more gradual, but also more chronic, systemic activation of coagulation can proceed subclinically. Eventually this process may lead to exhaustion of platelets and coagulation factors and bleeding (for example at the site of the tumor) may be the first clinical symptom indicating the presence of DIC. In some cases, the clinical presentation of DIC in cancer may be reminiscent of thrombotic microangiopathies, which is understandable in view of the role of endothelium in both conditions. The therapeutic cornerstone of DIC is treatment of the underlying disorder but supportive treatment, specifically aimed at the hemostatic system may be required. •Activation of coagulation in cancer patients may lead to disseminated intravascular coagulation (DIC)•DIC in cancer is driven by induction of cytokine and expression of procoagulant factors on cancer cells, such as tissue factor or factor X-activating cancer procoagulant•Derangement of vascular endothelium plays a major role in the pathogenesis of cancer-induced DIC•In the management of cancer-associated DIC anticoagulants are crucial, whereas antifibrinolytic agents may be helpful to manage excessive hyperfibrinolysis and bleeding
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ISSN:0049-3848
1879-2472
1879-2472
DOI:10.1016/S0049-3848(16)30101-3