[Disseminated intravascular coagulation associated with hematologic malignancies]

Hematological malignancies that are frequently complicated with disseminated intravascular coagulation (DIC) include acute leukemia, high-grade malignant lymphoma, and cases undergoing certain immunotherapy or cellular therapy. In typical cases of DIC associated with hematological malignancies, bleeding symptoms are aggravated not only by the activated fibrinolytic system but also by thrombocytopenia induced by the underlying disease or anticancer therapy, and their management is of critical clinical interest. As such, antithrombotic therapy with heparinoids carries significant risk of bleeding complications. Other DIC treatments, such as thrombomodulin and antithrombin, are preferred, although none of them lack the high-quality evidence necessary to be strongly recommended. It is essential to diagnose DIC early using appropriate diagnostic criteria, comprehend the pathophysiology of each case, and select treatments based on an understanding of the benefits and potential risks of the individual therapeutic agents. The inclusion of replacement therapy with blood transfusions and blood products, the optimal intervention threshold for hematological malignancy-associated DIC, and strategies for identifying optimal cases that would most benefit from specific treatment, remain subjects for future investigation.