Activation of coagulation and deep vein thrombosis after bone marrow harvesting and insertion of a Hickman-catheter in ABMT patients with malignant lymphoma

Bone Marrow Transplant. 1996 Apr;17(4):577-81.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use
  • Antithrombin III / analysis
  • Biomarkers / blood
  • Blood Coagulation* / drug effects
  • Bone Marrow Transplantation*
  • Catheterization, Central Venous / adverse effects*
  • Circadian Rhythm
  • Female
  • Fibrin / analysis
  • Fibrinolysis / drug effects
  • Fibrinopeptide A / analysis
  • Heparin / pharmacology
  • Heparin / therapeutic use
  • Hodgkin Disease / classification
  • Hodgkin Disease / complications
  • Hodgkin Disease / therapy
  • Humans
  • Ilium / injuries*
  • Lymphoma / blood*
  • Lymphoma / complications
  • Lymphoma / therapy
  • Lymphoma, Non-Hodgkin / classification
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Peptide Fragments / analysis
  • Peptide Hydrolases / analysis
  • Plasminogen Activator Inhibitor 1 / analysis
  • Platelet Count
  • Premedication
  • Prothrombin / analysis
  • Sternum / injuries*
  • Subclavian Vein
  • Thrombophlebitis / etiology*
  • Transplantation, Autologous*
  • Wounds and Injuries / blood*
  • beta-Thromboglobulin / analysis

Substances

  • Anticoagulants
  • Biomarkers
  • Peptide Fragments
  • Plasminogen Activator Inhibitor 1
  • antithrombin III-protease complex
  • beta-Thromboglobulin
  • prothrombin fragment 1.2
  • Fibrinopeptide A
  • Antithrombin III
  • Prothrombin
  • Fibrin
  • Heparin
  • Peptide Hydrolases