Objective The mortality rate due to
disseminated intravascular coagulation (
DIC) is higher in patients with
lung cancer than in those without. We examined the effect of treatment with
thrombomodulin alfa (TM-α) for
DIC in
lung cancer patients. Methods Subjects were 57 patients with
DIC (43 men, 14 women; mean age, 71.7 years), comprising 31 with
lung cancer and 26 without.
DIC patients with or without
lung cancer did not differ significantly in their background characteristics. Results No significant difference was noted in the mortality rate between patients with
lung cancer (61.3%) and those without (57.7%). However, the dose of TM-α was higher for survivors with
lung cancer than for non-survivors (473.1 U/kg/day vs. 380.6 U/kg/day; p<0.01). Although no significant difference was noted in the
DIC score between these four groups, the serum
C-reactive protein level (6.9 mg/dL vs. 11.6 mg/dL; p<0.05) and prothrombin time-international normalized ratio (PT-INR; 1.10 vs. 1.52; p<0.05) were lower in survivors with
lung cancer than in the non-survivors with
lung cancer. The initial body temperature in non-survivors without
lung cancer was lower than that in survivors without
lung cancer (37.2°C vs. 37.9°C, p<0.01), and the platelet count and the time to recovery from
DIC in patients without
lung cancer showed a significant negative correlation (r2=0.438, p<0.05). Conclusion Our findings suggest that although 380 U/kg/day of TM-α is the recommended dose for
DIC treatment, a higher dose may reduce the mortality rate of
lung cancer patients with
DIC. Furthermore, TM-α should be initiated before worsening of
DIC parameters.