Klin Onkol 1992; 5(5): 135-140.
Hemostatic abnormalities are present in a majority of cancer patients. Disseminated intravascular coagulation (DIC) is a pathologic syndrome in which activation of intravascular coagulation may lead to hemorhagic diathesis and microvascular fibrin formation; the diffuse thrombosis may lead to irreversible end-organ dysfunction. Tissue injury and endothelial cell alteration (e.g.in infectious complications) appear to be two major mechanisms causing DIC in cancer patients. Clinical features represent a combination of the syndroms associated with underlying disease, coagulopathy and microvascular thrombosis leading to end-organ damage. Multiple bleeding sites are common in DIC patients. Laboratory diagnonsis of DIC is difficult because most of routine clotting tests are abnormal. Thrombocytopenia, low plasma fibrinogen, long prothrombin time, pozitive etanol test and elevated fibrin degradation products are often found. Therapy of DIC depends on the type of clinical manifestation. Treatment of underlying disease (malignancy and/or infectious complication) is the most important. Administration of low dose heparin could be of benefit due to interruption of clotting process. Replacement of coagulation factors is another important aspect of care in DIC patients. Chronic DIC as well as specific syndromes (thrombotic thrombocytopenic purpura, Trousseasus´s syndrom, microangiopatic hemolytic anemia and nonbacterial marantic endocarditis) are also reviewed.
