Immediate haemostasis with recombinant factor VIIa for haemorrhage following Hickman line insertion in acute myeloid leukaemia.
Bleeding following Hickman line insertion is not uncommon but can be life threatening, especially in the presence of coagulopathy and thrombocytopenia following chemotherapy. Treatment to control the bleeding can be challenging and treatment options are limited. We present our experience of a patient who had persisting haemorrhage immediately following Hickman line insertion for administration of chemotherapy for relapsed acute myeloid leukaemia. Haemostasis could not be achieved after FFP and platelet administration. A single dose of recombinant factor VIIa (rhFVIIa) stopped the bleeding immediately, avoiding the need for surgical intervention or line removal. Our experience indicates rhFVIIa may be an effective option for bleeding related to Hickman line insertion.
Osborne
W
W
BMT Unit and Department of Haematology, Royal Infirmary, Castle Street, Glasgow, UK.
Bhandari
S
S
Tait
R C
RC
Franklin
I M
IM
D000208:Acute Disease; D001780:Blood Coagulation Tests; D002404:Catheterization / Q000009:adverse effects*; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D006403:Hematologic Tests; D006470:Hemorrhage / Q000188:drug therapy*; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D007951:Leukemia, Myeloid / Q000097:blood* / Q000150:complications; D007964:Leukocytosis; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use*
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa