Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 3: solid cancers and vascular abnormalities.

IF 1.7 4区 医学 Q3 HEMATOLOGY International Journal of Hematology Pub Date : 2025-01-10 DOI:10.1007/s12185-024-03912-y
Yoshinobu Seki, Kohji Okamoto, Takayuki Ikezoe, Kazuma Yamakawa, Seiji Madoiwa, Toshimasa Uchiyama, Hidesaku Asakura, Shinya Yamada, Shin Koga, Hiroyasu Ishikura, Takashi Ito, Toshiaki Iba, Mitsuhiro Uchiba, Kaoru Kawasaki, Noriaki Kawano, Satoshi Gando, Shigeki Kushimoto, Yuichiro Sakamoto, Toshihisa Tamura, Kenji Nishio, Mineji Hayakawa, Takeshi Matsumoto, Toshihiko Mayumi, Hideo Wada
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Abstract

This study discusses disseminated intravascular coagulation (DIC) associated with solid cancers and various vascular abnormalities, both of which generally exhibit chronic DIC patterns. Solid cancers are among the most significant underlying diseases that induce DIC. However, the severity, bleeding tendency, and progression of DIC vary considerably depending on the type and stage of the cancer, making generalization difficult. Moreover, during the process of creating these guidelines, it became apparent that despite solid cancers being a major underlying condition for DIC, there is a lack of high-quality research on DIC associated with solid cancers. Nevertheless, we developed recommendations for clinical questions (CQs) regarding the use of heparin and recombinant thrombomodulin. Additionally, statements concerning these five questions were provided. DIC associated with various vascular abnormalities, is characterized by hyperfibrinolytic activity and linked to underlying conditions such as aortic aneurysm, aortic dissection, vasculitis syndromes, and vascular malformations. These conditions must always be considered differential diagnoses when unexplained thrombocytopenia or bleeding tendencies are observed. Although no evidence was found to support the assignment of recommendation levels, three statements were made. However, traumatic vascular abnormalities have not been discussed in this context.

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日本2024弥散性血管内凝血管理临床实践指南第三部分:实体癌和血管异常。
本研究讨论了与实体癌和各种血管异常相关的弥散性血管内凝血(DIC),这两种情况通常都表现为慢性DIC模式。实体癌是诱发DIC的最重要的潜在疾病之一。然而,DIC的严重程度、出血倾向和进展在很大程度上取决于癌症的类型和分期,这使得泛化很困难。此外,在制定这些指南的过程中,很明显,尽管实体癌是DIC的主要潜在疾病,但缺乏关于DIC与实体癌相关的高质量研究。尽管如此,我们提出了关于肝素和重组血栓调节素使用的临床问题(CQs)的建议。此外,还就这五个问题作了说明。DIC与多种血管异常相关,其特征是高纤溶活性,并与潜在疾病如主动脉瘤、主动脉夹层、血管炎综合征和血管畸形有关。当观察到不明原因的血小板减少症或出血倾向时,必须始终考虑这些情况的鉴别诊断。虽然没有发现证据支持推荐水平的分配,但有三种说法。然而,创伤性血管异常尚未在此背景下讨论。
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来源期刊
CiteScore
3.90
自引率
4.80%
发文量
223
审稿时长
6 months
期刊介绍: The International Journal of Hematology, the official journal of the Japanese Society of Hematology, has a long history of publishing leading research in hematology. The journal comprises articles that contribute to progress in research not only in basic hematology but also in clinical hematology, aiming to cover all aspects of this field, namely, erythrocytes, leukocytes and hematopoiesis, hemostasis, thrombosis and vascular biology, hematological malignancies, transplantation, and cell therapy. The expanded [Progress in Hematology] section integrates such relevant fields as the cell biology of stem cells and cancer cells, and clinical research in inflammation, cancer, and thrombosis. Reports on results of clinical trials are also included, thus contributing to the aim of fostering communication among researchers in the growing field of modern hematology. The journal provides the best of up-to-date information on modern hematology, presenting readers with high-impact, original work focusing on pivotal issues.
期刊最新文献
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