Comparison of gabexate mesilate and nafamostat mesilate for disseminated intravascular coagulation associated with hematological malignancies
- 97 Downloads
We evaluated clinical outcomes of disseminated intravascular coagulation (DIC) in patients with hematological malignancies treated with synthetic protease inhibitors (SPIs) and compared the effects of gabexate mesilate (FOY) and nafamostat mesilate (FUT). We retrospectively examined 127 patients [acute myeloid leukemia (n = 48), acute lymphoblastic leukemia (n = 25), and non-Hodgkin lymphoma (n = 54)] with DIC, who were diagnosed according to Japanese Ministry of Health, Labour and Welfare criteria and treated with SPIs [FOY (n = 55) and FUT (n = 72)] at our hospital from 2006 to 2015. The DIC resolution rates on days 7 and 14 were 42.6% and 62.4%, respectively. No significant differences were observed in DIC resolution rates between the FUT and FOY groups [40.3% vs. 45.5% (day 7), P = 0.586; 56.3% vs. 69.8% (day 14), P = 0.179, respectively]. Multivariate analysis revealed that response to chemotherapy was the only independent predictor of DIC resolution on days 7 and 14 (ORR 2.81, 95% CI 1.32–5.98, P = 0.007; ORR 2.51, 95% CI 1.12–5.65, P = 0.026). Resolution of DIC was correlated with improvement of background hematological malignancies, and no significant differences were observed between the two SPIs.
KeywordsDisseminated intravascular coagulation Gabexate mesilate Nafamostat mesilate Synthetic protease inhibitors Hematological malignancy
DM collected data and wrote the manuscript; SF collected data and wrote the manuscript; YK and TO designed this report, interpreted the results and wrote the manuscript; YS, TI, SK, YT, SI, SO, TN, KM, KU, HN, RY, KM, YK, MS, CY, MA, KH, KS, IO, KO, KM, reviewed the manuscript, contributed to the interpretation of the data, and approved the final version.
Compliance with ethical standards
Conflict of interest
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. We declare that we have no conflicts of interest.
- 7.Hitomi Y, Ikari N, Fujii S. Inhibitory effect of a new synthetic protease inhibitor (FUT-175) on the coagulation system. Haemostasis. 1985;15:164–8.Google Scholar
- 8.Kobayashi N, Maekawa T, Takada M, Tanaka H, Gonmori H. Criteria for diagnosis of DIC based on the analysis of clinical and laboratory findings in 345 DIC patients collected by the Research Committee on DIC in Japan. Bibl Haematol. 1983;49:265–75.Google Scholar
- 9.Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M, Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH). Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001;86:1327–30.CrossRefGoogle Scholar
- 11.Saito H, Maruyama I, Shimazaki S, Yamamoto Y, Aikawa N, Ohno R, et al. Efficacy and safety of recombinant human soluble thrombomodulin (ART-123) in disseminated intravascular coagulation: results of a phase III, randomized, double-blind clinical trial. J Thromb Haemost. 2007;5:31–41.CrossRefGoogle Scholar
- 15.Shibata S, Takahashi H, Aoki N, Takahashi H, Aoki N, Matsuda T, et al. Evaluation of clinical effect of FUT-175 on DIC: multi-center clinical comparative study. Rinsho Kenkyu. 1988;65:921–40.Google Scholar
- 16.Kosaki G, Kambayashi J, Hirabayashi A, Mori K, Uchida T, Abe T, et al. Evaluation of clinical effect of FOY on DIC: multi-center clinical comparative study. Igaku no Ayumi. 1983;124:144–54.Google Scholar