Marti-Carvajal, A.J., Anand, V., & Sola, I. (2015). Treatment for disseminated intravascular coagulation in patients with acute and chronic leukemia. Cochrane Database of Systematic Reviews, 6, CD008562.
STUDY PURPOSE: To assess the benefits and harms of pharmacologic interventions for treating patients with leukemia experiencing disseminated intravascular coagulation (DIC) to update a prior systematic review
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Not specified or not applicable
Interventions included human activated protein C versus heparin, recombinant human soluble thrombomodulin versus heparin, tanexamic acid versus placebo, and dermatan sulfate versus heparin. Only one study was found for each intervention. No significant differences in bleeding with protein C or dermatan sulfate existed. Recombinant human soluble thrombomodulin was associated with improvement in bleeding symptoms compared to heparin, and lower scoring of hemorrhagic problems with tranexamic acid compared to placebo.
Insufficient high quality evidence exists to fully evaluate these interventions.
Extremely limited evidence regarding the effects of pharmacologic interventions for the management of DIC and associated bleeding exists compared to usual practice using heparin.