title: Catheter-related complications in 52 patients treated with continuous infusion of low dose recombinant interleukin-2 via an implanted central venous catheter.
abstract: In this study we evaluated the catheter-related complications in 52 patients with advanced melanoma, renal cell cancer or non-Hodgkin's lymphoma treated with continuous infusion of low-dose recombinant interleukin-2 by central venous access (CVA) of the port-a-cath type. We noted a high incidence (55.5%) of catheter infection, defined as positive blood cultures drawn from the CVA in symptomatic or asymptomatic patients. Six infections were noted before rIL-2 treatment was started. Twelve of the 30 documented infections were symptomatic (fever and/or chills), with only four documented bacteraemias. The most frequently cultured microorganism was Staphylococcus epidermidis (73%). Treatment initially consisted of systemic antibiotics via the CVA, but as experience increased, the mostly asymptomatic CVA infections were not treated. In 30% of the documented CVA infections a thrombus at the tip of the catheter was found by radiological contrast examination. Local thrombosis can be effectively treated with constant infusion of low dose streptokinase via the CVA.
authors.affiliation: Department of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Huis, Amsterdam.
authors.forename: L T
authors.initials: LT
authors.lastname: Vlasveld
authors.forename: S
authors.initials: S
authors.lastname: Rodenhuis
authors.forename: E J
authors.initials: EJ
authors.lastname: Rutgers
authors.forename: A C
authors.initials: AC
authors.lastname: Dubbelman
authors.forename: A M
authors.initials: AM
authors.lastname: Hilton
authors.forename: D
authors.initials: D
authors.lastname: Batchelor
authors.forename: E M
authors.initials: EM
authors.lastname: Rankin
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007376:Interleukin-2 / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D015366:Pefloxacin / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage; D013927:Thrombosis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D007376:Interleukin-2; D011994:Recombinant Proteins; D015366:Pefloxacin