Low ADAMTS-13 activity during hemorrhagic events with disseminated intravascular coagulation
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- 作者：Yoshiaki Chinen (1)
Junya Kuroda (1)
Muneo Ohshiro (1) (2)
Yuji Shimura (1)
Shinsuke Mizutani (1)
Hisao Nagoshi (1)
Nana Sasaki (1)
Ryuko Nakayama (1)
Miki Kiyota (1)
Mio Yamamoto-Sugitani (1)
Tsutomu Kobayashi (1)
Yosuke Matsumoto (1)
Shigeo Horiike (1)
Masafumi Taniwaki (1) - 关键词：ADAMTS ; 13 ; Disseminated intravascular coagulation ; Hemorrhagic events ; Hematologic disorders
- 刊名：International Journal of Hematology
- 出版年：2013
- 出版时间：April 2013
- 年：2013
- 卷：97
- 期：4
- 页码：511-519
- 全文大小：360KB
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Junya Kuroda (1)
Muneo Ohshiro (1) (2)
Yuji Shimura (1)
Shinsuke Mizutani (1)
Hisao Nagoshi (1)
Nana Sasaki (1)
Ryuko Nakayama (1)
Miki Kiyota (1)
Mio Yamamoto-Sugitani (1)
Tsutomu Kobayashi (1)
Yosuke Matsumoto (1)
Shigeo Horiike (1)
Masafumi Taniwaki (1)
1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
2. Department of Hematology, Kyoto First Red Cross Hospital, Kyoto, Japan
文摘
Disseminated intravascular coagulation (DIC) is a life-threatening complication, and its control is essential for therapeutic success. Recombinant human soluble thrombomodulin alfa (rTM) is a novel therapeutic agent for DIC. The efficacy of rTM in the treatment of DIC is reportedly superior to that of conventional anti-DIC treatments, such as unfractionated heparin or low molecular weight heparin, but hemorrhagic events occasionally interfere with the therapeutic benefits of rTM. We assessed the clinical features of 20 consecutive patients who were given rTM for DIC associated with various hematologic disorders. Eight patients achieved remission of both primary disease and DIC, eight died due to progression of the primary disease, and four died of various hemorrhagic complications. Assessment of 16 biomarkers for coagulation showed that the four patients who died of hemorrhagic complications despite remission of their primary disease showed lower ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin Type 1 motif, member 13) plasma activity than other patients (P?=?0.016). The optimal cut-off level of ADAMTS-13 for predicting risk of hemorrhagic complications was 42?% (P?=?0.007). Plasma ADAMTS-13 activity determined at diagnosis of DIC may help predict the risk of hemorrhagic events during and/or following DIC treatment with hematologic disorders.