title: Low molecular weight heparin for Hickman catheter--induced thrombosis in thrombocytopenic patients undergoing bone marrow transplantation.
abstract: BACKGROUND
  Patients with an indwelling central venous catheter are prone to development of thrombotic complications. Thrombocytopenia in patients undergoing bone marrow transplantation (BMT) generally is protracted. The management of thrombosis in thrombocytopenic patients is difficult because heparin and warfarin are relatively contraindicated because of the high risk of major bleeding. Low molecular weight heparin (LMWH) is a new class of antithrombotic drug. Enoxaparin (Rhone Poulenc Rorer, Antony, France) is an LMWH that has been shown to be effective in the treatment and prophylaxis of venous thrombosis. Enoxaparin, with its high antithrombotic to anticoagulant ratio, may be safer than standard heparin in patients at high risk of hemorrhagic complications.
  
  
  METHODS
  The authors report the cases of five thrombocytopenic patients, undergoing autologous BMT, in whom venous thrombosis developed related to a Hickman catheter.
  
  
  RESULTS
  All the patients were treated with Enoxaparin and recovered promptly without hemorrhagic complications.
  
  
  CONCLUSIONS
  The authors suggest that Enoxaparin is an effective drug in treating thrombocytopenic patients in whom acute venous thrombosis develops.
authors.affiliation: Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: P E
authors.initials: PE
authors.lastname: Drakos
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.forename: R
authors.initials: R
authors.lastname: Or
authors.forename: S
authors.initials: S
authors.lastname: Gillis
authors.forename: S
authors.initials: S
authors.lastname: Slavin
authors.forename: A
authors.initials: A
authors.lastname: Eldor
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D013921:Thrombocytopenia / Q000150:complications / Q000188:drug therapy*; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D006495:Heparin, Low-Molecular-Weight