Gastric cancer associated with acute disseminated intravascular coagulation: Successful initial treatment with weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin
Journal
British Journal of Haematology
Journal Volume
100
Journal Issue
4
Pages
769-772
Date Issued
1998
Author(s)
Abstract
Acute disseminated intravascular coagulation (DIC) is a severe complication of gastric adenocarcinoma, and most of the patients die within 1-3 weeks. We have treated five such patients with an empirical nonmyelosuppressive HDFL regimen (weekly 24 h infusion of high-dose 5- fluorouracil 2600 mg/m2 and leucovorin 300 mg/m2). Within 2 weeks of starting the treatment the clinical and laboratory evidence of acute DIC quickly resolved in all five patients. HDFL not only caused no further myelosuppression, but also resulted in normalization of the patient's haemogram within a few weeks. Other anti-cancer drugs could then be safely added. Three patients had a survival time of more than 6 months. We suggest that HDFL is an ideal initial treatment for gastric cancer complicated by acute DIC.
SDGs
Other Subjects
cisplatin; etoposide; fluorouracil; folinic acid; acute disease; adult; aged; article; blood clotting disorder; clinical article; clinical trial; disseminated intravascular clotting; drug megadose; drug response; female; human; intravenous drug administration; male; priority journal; stomach adenocarcinoma; survival time; thrombocytopenia; treatment outcome; Adult; Aged; Antidotes; Antimetabolites, Antineoplastic; Disease-Free Survival; Disseminated Intravascular Coagulation; Female; Fluorouracil; Humans; Infusions, Intravenous; Leucovorin; Male; Middle Aged; Stomach Neoplasms; Survival Analysis; Thrombocytopenia; Treatment Outcome
Type
journal article