The off-label use of recombinant FVIIa in the treatment of a patient with T-cell non-Hodgkin lymphoma who developed intra-abdominal and intra-pleural hemorrhages followed by high-dose methotreaxate therapy

Erduran E., Bahadır A., Mutlu M.

European journal of Clinical and Medical Oncology, vol.3, no.5, pp.1-4, 2011 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 3 Issue: 5
  • Publication Date: 2011
  • Journal Name: European journal of Clinical and Medical Oncology
  • Journal Indexes: Scopus
  • Page Numbers: pp.1-4
  • Keywords: Methotreaxate, Non-Hodgkin lymphoma, Recombinant FVII
  • Karadeniz Technical University Affiliated: Yes


Methotreaxate (MTX) is a folat inhibitor that inhibits DNA, RNA, and protein synthesis. MTX has a lot of side effects especially on the gastrointestinal system such as mucositis, ulcerative stomatit, nausea, vomiting, diarrhea, and hepatic toxicity. Here we reported a 13-yearold girl patient in association with T-cell lymphoblastic non-Hodgkin lymphoma who developed an excessive intra-abdominal and intrathorasic hemorrhage unresponsive to fresh frozen plasma and thrombocyte transfusions followed by high-dose MTX treatment. Also discussed is the off-label use of rFVIIa in the patients with excessive bleeding unresponsive to conventional treatment. This patient received rFVIIa in a dose of 50 mg/kg every 2 h for three doses (total 300 mg/kg). We suggest that the rFVIIa treatment is effective for excessive bleeding unresponsive to conventional treatment caused by high-dose MTX treatment and the off-label use of rFVIIa may be thought of in the treatment of excessive hemorrhages followed by MTX treatment.