Suppression of heparinization of central venous catheters between cycles of chemotherapy. Results of a phase I study.
A phase I study to evaluate heparinization of tunnelled subclavian catheters (TSC) was conducted in 42 patients who each had a TSC for chemotherapy. They were enrolled in the study from August 1994 to December 1995. The inclusion criteria were: age 18-70, no general anticoagulant treatment, TSC used only for chemotherapy, informed consent. Heparinization was performed at the end of each cycle and then at increasing intervals: 11, 13, 15, 17, 19, and 21 days. A 21-day interval was intended to mimic the suppression of heparinization between cycles. Heparinization was performed with a 250 IU/ml heparin solution. Anti-Xa activity was studied before each heparinization. For each interval, at least 5 patients were followed up for two cycles. If no blockages were present progression to the next step was authorized. If one blockage was observed 5 additional patients were required to have their TSCs heparinized after the same interval. Two blockages (block) after the same interval meant that the previous interval was recorded as the longest tolerable. There were no blocks with the 11-day interval (6 patients), 1 block after 13 days (10 patients), 1 block after 15 days (10 patients), and no blocks after 17 days (5 patients), 19 days (6 patients), or 21 days (5 patients). The median anti-Xa activity (curative rate 0.2-0.6) was, respectively 11 days 6.74; 13 days 5.47; 15 days 4.71; 17 days 3.61; 19 days 3.67; 21 days 5.10 (NS). Heparinization between two cycles of chemotherapy is unnecessary. A high level of heparin activity persisted constantly inside the catheter lumen through the 3-week observation period.
Service d' Oncologie Médicale, Centre Paul Papin, Angers, France.
R
R
Delva
E
E
Gamelin
A
A
Lortholary
P
P
Maillart
P
P
Leynia de la Jarrige
C
C
Girault
J
J
Guérin
F
F
Larra
D000230:Adenocarcinoma / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D003251:Constriction, Pathologic / Q000517:prevention & control; D004334:Drug Administration Schedule; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D006493:Heparin