[Treatment of DIC associated with hematological malignancies]

To improve the prognosis of patients with hematological malignancies, close attention should be paid to major hemorrhage in the clinical management of patients with disseminated intravascular coagulation (DIC) associated with hematological malignancies, especially from diagnosis to induction therapy. Cerebral, alveolar, and GI tract hemorrhages may cause a life-threatening event. Therefore, DIC should always be suspected, and careful observation for hemorrhage and hemostatic examination should be performed. The diagnostic criteria for DIC according to the Japanese Ministry of Health and Welfare and the Japanese Society on Thrombosis and Hemostasis (2017) are useful resources for the diagnosis of DIC associated with hematological malignancies. Following diagnosis, treatment for DIC should be initiated as soon as possible, and the risk of hemorrhage should be considered when choosing the anticoagulant. Sufficient amount of fresh frozen plasma or platelet concentrates should be used if necessary. Recombinant human soluble thrombomodulin has promising potential for use as a drug for the treatment of DIC associated with hematological malignancies that can manage a wide range of pathologic processes such as hypercoagulable states, inflammation, excessive fibrinolysis, and easy hemorrhage caused by endothelial cell damage.