Haematologica Reports 2005; 1(issue 9): 52-53
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Prevention of disseminated intravascular coagulation in
cancer
Levi M
Academic Medical Center, University of Amsterdam, the
Netherlands
Disseminated intravascular coagulation (DIC) is a syndrome that
may complicate a variety of diseases, including malignant
disease.1 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). It is
not clear to what extent the manifestation of clinically overt
thrombo-embolism can be ascribed to malignancy-associated DIC.
There is ample evidence for a pro-coagulant state in virtually all
patients with advanced malignant disease, however, the incidence of
overt DIC appears to be much lower.2
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.3 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.
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