Recombinant factor VIIa (rFVIIa) may be useful in management of severe bleeding in paediatric oncology patients. We described our experience and outcomes in a form of a case series. In all cases, indication was massive gastrointestinal bleeding with haemodynamic instability, persistent thrombocytopenia and coagulopathy despite correction. The range of doses used was 88–102 mcg/kg/dose. Each patient received at least 3 doses. The use of rFVIIa resulted in a reduction in blood product support requirement. rFVIIa was effective in 2 out of 3 patients in stopping the bleeding. There were no drug-related complications. rFVIIa has a critical role to play in the early management of severe bleeding in critically ill paediatric oncology patients.
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