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 samp les 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 fi ve low-grade disease, The plasma levels of markers of activation (prot hrombin fragment 1 + 2, thrombin-antithrombin complexes, fibrinopeptid e A and fibrinmonomers) increased significantly (P < 0.001) in associa tion with harvesting, Except for fibrinopeptide A, the indicators of a ctivation were still significantly elevated 24 h after marrow aspirati on, beta-thromboglobulin, a marker of the platelet release reaction, a lso increased significantly (P < 0.01), Four out of nine patients in w hom 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 patients 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 prev ent the development of symptomatic deep vein thrombosis.