1987 年 28 巻 10 号 p. 1771-1777
We studied the clinical course and hemostatic parameters in 36 patients with solid cancers associated with microangiopathic hemolytic anemia (MHA). Twenty two patients had stomach cancers and 31 casaes had the metastasis to their bone marrows. ALL cases were associated with disseminated intravascular coagulation (DIC). Patients with solid cancers and MHA had severe clinical symptoms, especially cerebral bleeding (16 cases), cerebral thrombosis (4 cases) and other organ failure (4 cases), and 50% of the patients died within 3 weeks. The mean survival period was 48.0±86.0 days.
A coagulation study revealed a slightly reduced fibrinogen level and an elevated erythrocyte segmentation rate, making the diagnosis of DIC tobe difficult. However, these patients had markedly elevated FDP values, decreased platelet counts, severe bleeding tendency and thrombosis. DIC could be effectively treated in only a few patients, and these patients survived longer. Frequent examination of blood coagulation and chemistry shuld be performed in patients with solid cancers. In addition, it is necessary to determine the phase at which hemostatic abnormality occurs in these patients and treated DIC in the early stage.