Tang Yaqiong, Wu Qian, Wu Xiaojin, Qiu Huiying, Sun Aining, Ruan Changgeng, Wu Depei, Han Yue
Yaqiong Tang, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis & Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China. Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
Qian Wu, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis & Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China. Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
Pak J Med Sci. 2015 Nov-Dec;31(6):1389-93. doi: 10.12669/pjms.316.8357.
Recombinant-activated factor VII (rVIIa) is a vitamin K-dependent glycoprotein that is an analog of the naturally occurring protease. It has an off-label use to control life-threatening bleeding that is refractory to other measures and was shown to decrease transfusion requirements. Gastrointestinal (GI) bleeding is a severe complication following hematopoietic stem cell transplantation (HSCT) in patients with thrombocytopenia, while hemostatic measures based on antifibrinolytic or transfusion therapy may not always be successful. The present study investigated the treatment with rFVIIa in severe GI bleeding among thrombocytopenia patients undergoing HSCT.
rFVIIa was given as a single dose of 60μg/kg in patients with GI bleeding following hematopoietic stem cell transplantation (HSCT).
Among all patients enrolled, 12 (75%) of 16 patients obtained a response, of which 5 achieved a complete response and 7 achieved a partial response. The 4 remiaing patients (25%) had no response. Nine patients (56.3%) died in a follow-up of 90 days. No thromboembolic events wereassociated with the drug administration occurred.
Our study showed that rFVIIa may represent an additional therapeutic option in such cases.
重组活化因子VII（rVIIa）是一种维生素K依赖糖蛋白，是天然存在的蛋白酶的类似物。它可用于控制对其他措施无效的危及生命的出血，且已证明可减少输血需求。胃肠道（GI）出血是血小板减少症患者造血干细胞移植（HSCT）后的严重并发症，而基于抗纤溶或输血治疗的止血措施不一定总能成功。本研究调查了rFVIIa对接受HSCT的血小板减少症患者严重胃肠道出血的治疗效果。
对造血干细胞移植（HSCT）后出现胃肠道出血的患者给予单剂量60μg/kg的rFVIIa。
在所有入组患者中，16例患者中有12例（75%）有反应，其中5例完全缓解，7例部分缓解。其余4例患者（25%）无反应。9例患者（56.3%）在90天的随访中死亡。未发生与药物给药相关的血栓栓塞事件。
我们的研究表明，rFVIIa可能是此类病例的另一种治疗选择。
