Key result
In a 13-year-old boy with metastatic alveolar rhabdomyosarcoma and massive DIC, prompt systemic chemotherapy and aggressive supportive care temporarily resolved DIC, though he died 1 year later from disease progression.
Case Report (n=1)
In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care can help decrease malignancy-triggered procoagulant activities.
May support chemotherapy for DIC control in metastatic rhabdomyosarcoma; hypothesis-generating and should not yet change practice.
It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide, the patients' laboratory indications of DIC began to resolve. During this period, the patient received massive blood transfusion of a total of 311 units (26 units of red blood cells, 26 units of fresh frozen plasma, 74 units of platelet concentrates, 17 units of single donor platelets, and 168 units of cryoprecipitate), antithrombin-III and a synthetic protease inhibitor. Despite chemotherapy and radiation therapy, he died 1 year later because of disease progression. In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care is important to decrease malignancy-triggered procoagulant activities.
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Yoon et al. (2015) conducted a case report in Alveolar rhabdomyosarcoma with massive disseminated intravascular coagulopathy (n=1). Systemic chemotherapy (vincristine, doxorubicin, and cyclophosphamide) and supportive care was evaluated on Resolution of DIC and survival. In a 13-year-old boy with metastatic alveolar rhabdomyosarcoma and massive DIC, prompt systemic chemotherapy and aggressive supportive care temporarily resolved DIC, though he died 1 year later from disease progression.
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