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Colegio de Medicina Interna de México.

2009, Number 1

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Med Int Mex 2009; 25 (1)

Recombinant factor VII in the treatment of refractory microvascular bleeding in patients with hematologic malignancies. A report of two cases and bibliographic review

Carrillo ER, Sánchez ZMJ, Castro PJF, Arenas ZD

Language: Spanish
References: 15
Page: 67-72
PDF size: 573.45 Kb.


ABSTRACT

Bleeding is an important cause of morbidity and mortality in patients with malignancies, particularly in patients with leukemia, in whom hemorrhage has been reported in up to 90% of cases. Recombinant FVIIa (rFVIIa) was developed primarily for the treatment of hemophilia A or B with inhibitors. In recent years, the use of rFVIIa has been widely extended to treat patients with bleeding diatheses of various causes. rFVIIa has been used in a diverse clinical bleeding situations such as platelet disorders, trauma, liver disease and uncontrolled coagulopathy, when all other therapeutic options have failed. In this paper we report two patients with hematologic malignancies with severe bleeding refractory to conventional therapy that were successfully treated with rFVIIa. The use of rFVIIa was well tolerated. Our data and the literature suggests that rFVIIa is beneficial in the management of hemorrhage in patients with hematologic malignancies and massive microvascular bleeding. This warrants further investigation in rigorously controlled clinical trials. To the best of our knowledge this is the only paper in our country which describes and objectively documents successful hemostasis in patients with hematologic malignancies with rFVIIa.


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