Summary
We examined 395 patients with disseminated intravascular coagulation (DIC) divided
into two groups: non-leukemic and leukemic. In 58% of the patients as a whole, treatment
of DIC resulted in complete or partial remission, while exacerbation and death occurred
in 31%. The efficacy of DIC treatment in the non-leukemic group was less than that
in the leukemic group, indicating that the outcome of DIC depended, in part, on the
underlying disease. We examined hemostatic indicators in relation to DIC score: prothrombin
time (PT) ratio, FDP, platelet count, and fibrinogen levels were found to be important
indicators for the diagnosis of DIC, but not for Pre-DIC. Plasma levels of fibrin-D-dimer,
thrombin-antithrombin complex (TAT), and plasmin- plasmin inhibitor complex (PPIC)
were significantly increased in pre-DIC. The efficacy of treatment in relation to
the DIC score when the treatment was begun showed that greater efficacy was achieved
in pre-DIC than in DIC patients. The outcome was poorer with increasing DIC score,
suggesting that early diagnosis and early treatment are important. On examining the
relationship between outcome and hemostatic indicators, we found that the PT ratio
and the levels of antithrombin, plasminogen, PPIC, the PPIC/TAT ratio, and thrombomodulin
were related to outcome, suggesting that very high consumption of blood coagulation
factors, liver dysfunction, hypofibrinolysis, or organ failure caused a poor outcome.
Although the outcome in DIC patients may not depend substantially on plasma levels
of TAT and fibrin-D- dimer, we can use these indicators to treat DIC patients at an
early stage.
