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Thromb Haemost 2001; 86(03): 828-833
DOI: 10.1055/s-0037-1616139
Review Articles
Schattauer GmbH

Disseminated Intravascular Coagulation in Solid Tumors: Clinical and Pathologic Study

Sabah Sallah
1   Division of Hematology/Oncology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
,
Jim Y. Wan
2   Department of Biostatistics, University of Tennessee, Memphis
,
Nam P. Nguyen
3   Radiation Oncology, Southwestern University, Dallas, Texas
,
L. R. Hanrahan
4   Department of Pathology and Laboratory Medicine, East Carolina University, Greenville, North Carolina
,
George Sigounas
5   Division Hematology and Bone Marrow Transplantation, East Carolina University, Greenville, North Carolina, USA
› Author Affiliations
Further Information

Publication History

Received 15 December 2000

Accepted after resubmission 20 April 2001

Publication Date:
14 December 2017 (online)

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Summary

Disseminated intravascular coagulation (DIC) is a well known hemostatic complication of solid tumors. We evaluated the occurrence of DIC in 1117 patients with solid tumors. Of these patients, 76 (6.8%) were diagnosed with DIC. There were a total of 145 bleeding and clotting episodes reported in the 76 patients. Thrombocytopenia, hypofibrinogemia, elevated D-dimer and fibrinogen degradation products were the most common coagulation abnormalities encountered in patients with DIC. In multivariate analysis, older age (p = .0001), male gender (p = .009), advanced malignancies (p = .027), breast cancer (p = .038) and the presence of necrosis in the tumor specimen (p = .004), emerged as independent factors significantly related to the occurrence of DIC in patients with solid tumors. Of the 76 patients, 25 (33%) achieved response to treatment of DIC as defined in the study. Patients with early stage and advanced malignancies who developed DIC had inferior survival when compared with their counterparts without DIC (p = .039 and p = .005, respectively). Taken together, this study indicates that certain clinical and laboratory features are more common in patients with solid tumors who developed DIC. The occurrence of DIC appears to have an independent effect on survival of patients with cancer. Cooperative studies are encouraged to better address the usefulness and optimal prophylactic heparin regimen in patients at risk for DIC.

Keywords

Disseminated intravascular coagulation - fibrinolysis - cancer
 

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