Abstract
Disseminated intravascular coagulation (DIC) is a complication that may be experienced by patients with solid tumors. The prognosis of solid tumors with DIC is much poorer than those without DIC. Although treatment of the underlying disease is critical for improvement of DIC, the efficacy and safety of chemotherapy in patients with DIC associated with colorectal cancer are not clear. A 50-year-old man with advanced rectal cancer and multiple liver metastases experienced DIC during third-line treatment with cetuximab plus irinotecan, following 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX) plus bevacizumab and 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) plus bevacizumab. Combination chemotherapy consisting of FOLFOX plus bevacizumab was reintroduced. Although platelet and fresh-frozen plasma transfusions were required daily before chemotherapy, the patient’s laboratory values improved after two cycles of chemotherapy, without severe toxicity. The patient was discharged, and FOLFOX plus bevacizumab has been continued on an outpatient basis without sign of recurrence of DIC as of December 2010 (4 months after initiation of chemotherapy). This case suggests that reintroduction of combination chemotherapy with FOLFOX plus bevacizumab is effective and feasible in patients with colorectal cancer with DIC and that chemotherapy may be a treatment option for such patients.
Similar content being viewed by others
References
Sallah S, Wan JY, Nguyen NP et al (2001) Disseminated intravascular coagulation in solid tumors: clinical and pathologic study. Thromb Haemost 86:828–833
Nonaka K, Sha S, Ito M et al (2010) A case of poorly differentiated adenocarcinoma of the rectum with disseminated carcinomatosis of the bone marrow successfully treated with mFOLFOX-6/bevacizumab (in Japanese). Nippon Shokakibyo Gakkai Zasshi 107:1151–1158
Taylor FB Jr, Toh CH, Hoots WK et al (2001) Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 86:1327–1330
Maindrault-Goebel F, Tournigand C, de Gramont A et al (2004) Oxaliplatin reintroduction in patients previously treated with leucovorin, fluorouracil and oxaliplatin for metastatic colorectal cancer. Ann Oncol 15:1210–1214
de Gramont A, Buyse M, Abrahantes JC et al (2007) Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer. J Clin Oncol 25:3224–3229
Leitao MM Jr, Hummer A, Dizon DS et al (2003) Platinum retreatment of platinum-resistant ovarian cancer after nonplatinum therapy. Gynecol Oncol 91:123–129
Welch S, Spithoff K, Rumble RB et al (2010) Bevacizumab combined with chemotherapy for patients with advanced colorectal cancer: a systematic review. Ann Oncol 21:1152–1162
Naing A, Kurzrock R et al (2010) Chemotherapy resistance and retreatment: a dogma revisited. Clin Colorectal Cancer 9:E1–E4
Conflict of interest
No author has any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Mizota, A., Shitara, K., Kondo, C. et al. A case of heavily pretreated rectal cancer with disseminated intravascular coagulation that improved following reintroduction of FOLFOX plus bevacizumab. Int J Clin Oncol 16, 766–769 (2011). https://doi.org/10.1007/s10147-011-0242-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-011-0242-2