Therapeutic Options in Patients with DIC and Cancer

Malignant disease may be complicated by the occurrence of disseminated intravascular coagulation (DIC) in 7–20% of cases [1]. In particular, adenocarcinoma and hematological malignancies are relatively frequently complicated by DIC [2, 3]. Clinically, DIC in cancer has in general a less fulminant presentation than the types of DIC complicating sepsis and trauma. A more gradual, but also more chronic, systemic activation of coagulation can proceed subclinically [4]. The manifestation of DIC may be merely thrombotic, with obstruction of the microvasculature of various organs but more frequently venous thromboembolism occurs [5]. Although the pathogenesis of DIC in patients with cancer follows similar pathways as in other underlying causes of DIC, some pathogenetic features are quite specific for malignant diseases [6, 7]. In the following, a brief overview of the pathogenesis of DIC in cancer will be given, with an emphasis of those pathways that provide a point of impact for (supportive) treatment strategies in patients with cancer and DIC.