Prophylaxis of central venous catheter-related thrombosis with minidose warfarin: analysis of its use in 427 cancer patients.
BACKGROUND
In the past few years, several studies have been performed to evaluate thrombosis prophylaxis with warfarin in cancer patients with central venous catheters (CVC), but the analysis of these studies does not allow firm conclusions to be drawn.


METHODS
Four hundred and twenty-seven cancer patients were evaluated. Each received warfarin at a dose of 1 mg/daily as prophylaxis, starting the day after CVC positioning until its removal.


RESULTS
The catheters were monitored for a mean of 168 days (range 22-706). There were 9 thrombotic events (1.8%). Overall, International Normalised Ratio (INR) elevation occurred in 55 (12.8%) patients. Bleeding was observed in 15 (3.5%) patients, 10 of whom had elevated INR levels. Of these, all were treated with continuous-infusion 5-Fluorouracil (5-FU)-based regimens.


CONCLUSIONS
Minidose warfarin can protect from clinical thrombosis, but can induce an alteration in INR values and/or haemorrhagic symptoms in patients being treated with 5-FU-based regimens.
Magagnoli
Massimo
M
Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, Italy. massimo.magagnoli@humanitas.it
Masci
Giovanna
G
Castagna
Luca
L
Zucali
Paolo Andrea
PA
Morenghi
Emanuela
E
Pedicini
Vittorio
V
Santoro
Armando
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
D000925:Anticoagulants; D014859:Warfarin