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Disseminated Intravascular Coagulation

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In paediatric oncology, this is most often seen with:

  • gram negative sepsis

  • AML at diagnosis particularly M3 and M4/5

  • advanced neuroblastoma (particularly stage 4S)

  • ALL with hyperleucocytosis

  • haemophagocytic syndromes.

Diagnosis is confirmed by prolonged PT, APTT, low platelets, low fibrinogen and high fibrin degradation products (latter measured as D-dimer concentration).

Treatment of DIC

  • treat underlying cause
  • keep platelets > 50 x 109/l
  • FFP 10 - 15 mls/kg over 1 -2 hours repeated 8 -12 hourly if necessary
  • cryoprecipitate 5 - 10 mls/kg over 1 hour given 8 - 12 hourly as necessary.

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  • Date last published: 02 August 2010
  • Document type: Clinical Guideline
  • Services responsible: National Child Cancer Network