Comparison of gabexate mesilate and nafamostat mesilate for disseminated intravascular coagulation associated with hematological malignancies

• Published in: International journal of hematology Vol. 109; no. 2; pp. 141 - 146
• Main Authors: Minakata, Daisuke, Fujiwara, Shin-ichiro, Ikeda, Takashi, Kawaguchi, Shin-ichiro, Toda, Yumiko, Ito, Shoko, Ochi, Shin-ichi, Nagayama, Takashi, Mashima, Kiyomi, Umino, Kento, Nakano, Hirofumi, Yamasaki, Ryoko, Morita, Kaoru, Kawasaki, Yasufumi, Sugimoto, Miyuki, Yamamoto, Chihiro, Ashizawa, Masahiro, Hatano, Kaoru, Sato, Kazuya, Oh, Iekuni, Ohmine, Ken, Muroi, Kazuo, Ohmori, Tsukasa, Kanda, Yoshinobu
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2019; Springer Nature B.V
• Subjects: Acute lymphoblastic leukemia; Acute myeloid leukemia; Chemotherapy; Coagulation; Disseminated intravascular coagulation; Hematology; Leukemia; Lymphatic leukemia; Lymphoma; Medicine; Medicine & Public Health; Multivariate analysis; Myeloid leukemia; Oncology; Original Article; Patients; Protease inhibitors; Proteinase inhibitors; Disseminated intravascular coagulation; Synthetic protease inhibitors; Gabexate mesilate; Hematological malignancy; Nafamostat mesilate
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-018-02567-w

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.