Activation of coagulation and deep vein thrombosis after bone marrow harvesting and insertion of a Hickman-catheter in ABMT patients with malignant lymphoma.
Evidence of activation of coagulation was sought in serial plasma samples from 25 ABMT candidates with malignant lymphoma admitted for bone marrow harvesting: 10 females and 15 males, median age 41 years (range 27-58 years). Nineteen patients had non-Hodgkin's lymphoma (NHL) and six had Hodgkin's disease. Of those with NHL, 14 had high-grade and five low- grade disease. The plasma levels of markers of activation (prothrombin fragment 1 + 2, thrombin-antithrombin complexes, fibrinopeptide A and fibrinmonomers) increased significantly (P < 0.001) in association with harvesting. Except for fibrinopeptide A, the indicators of activation were still significantly elevated 24 h after marrow aspiration. Beta-thromboglobulin, a marker of the platelet release reaction, also increased significantly (P < 0.01). Four out of nine patients in whom a long-term central venous catheter was inserted just after marrow aspiration, developed catheter-related deep vein thrombosis, verified venographically, shortly after harvesting. These results suggest that patient with malignant lymphoma undergoing marrow harvesting develop a hypercoagulable state, and that insertion of a central intravenous catheter immediately after marrow harvesting should be avoided to prevent the development of symptomatic deep vein thrombosis.
Sletnes
K E
KE
Haematological Research Laboratory, Ullevål University Hospital, Oslo, Norway.
Holte
H
H
Halvorsen
S
S
Jakobsen
E
E
Wisløff
F
F
Kvaløy
S
S
D000328:Adult; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D016026:Bone Marrow Transplantation; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002940:Circadian Rhythm; D005260:Female; D005337:Fibrin / Q000032:analysis; D005342:Fibrinolysis / Q000187:drug effects; D005344:Fibrinopeptide A / Q000032:analysis; D006493:Heparin / Q000494:pharmacology / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000145:classification / Q000150:complications / Q000628:therapy; D006801:Humans; D007085:Ilium / Q000293:injuries*; D008223:Lymphoma / Q000097:blood* / Q000150:complications / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010447:Peptide Hydrolases / Q000032:analysis; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis; D010976:Platelet Count; D011292:Premedication; D011516:Prothrombin / Q000032:analysis; D013249:Sternum / Q000293:injuries*; D013350:Subclavian Vein; D013924:Thrombophlebitis / Q000209:etiology*; D014182:Transplantation, Autologous; D014947:Wounds and Injuries / Q000097:blood*; D001620:beta-Thromboglobulin / Q000032:analysis
D000925:Anticoagulants; D015415:Biomarkers; D010446:Peptide Fragments; D017395:Plasminogen Activator Inhibitor 1; C046193:antithrombin III-protease complex; D001620:beta-Thromboglobulin; C045879:prothrombin fragment 1.2; D005344:Fibrinopeptide A; D000990:Antithrombin III; D011516:Prothrombin; D005337:Fibrin; D006493:Heparin; D010447:Peptide Hydrolases