Hemorrhagic complications in bone marrow transplant: possible roles of recombinant activated coagulation factor VII

Abstract

SUMMARY Severe hemorrhage is a rare but significant complication in bone marrow transplant. Central nervous system bleeding, gastrointestinal bleeding, hemorrhagic cystitis and diffuse alveolar hemorrhage account for most life‐threatening causes of hemorrhage. Thrombocytopenia, adverse therapeutic interactions, infections and treatment‐related organ injury are contributing factors. Thus, careful monitoring of global hemostasis function during transplantation is prudent. Therapeutic intervention for hemorrhagic complications in addition to transfusion may include factor concentrates such as recombinant factor VIIa (rFVIIa).

The potential role of recombinant activated FVII in the management of critical hemato-oncological bleeding: a systematic review

“…10 The first description was made in 1999 by White et al, 13 who described the successful use of rFVIIa in the treatment of pulmonary hemorrhage secondary to Aspergillus in a patients with acquired FVII deficiency undergoing treatment for acute myeloid leukemia (AML). The largest case series was that recently reported by Brenner et al 27 The authors, using an Internet-based registry (www.haemostasis.…”

“…The use of rFVIIa in bone marrow transplant Bleeding complications are relatively common in bone marrow transplantation (BMT), [10][11][12] although the reported risk of hemorrhage varies widely between the different series because of differences in conditioning regimens, patient populations and diseases transplanted.…”

“…After reading the titles and abstracts, we excluded 36 irrelevant references and retrieved 38 references for further assessment. A further five studies were excluded because they were reviews (three articles) [10][11][12] or duplicates (two articles). Thus, a total of 33 articles/abstracts, including 162 hemato-oncological patients treated with rFVIIa, were retrieved from this literature search (31 articles and two abstracts).…”