PREVENTION OF POSTOPERATIVE DEEP-VEIN THROMBOSIS IN CANCER-PATIENTS -A RANDOMIZED TRIAL WITH LOW-MOLECULAR-WEIGHT HEPARIN (CY-216)

Sixty-one consecutive patients were enrolled in a randomized, controll ed trial of thromboprophylaxis with a low molecular weight heparin (Se leparina, CY 216) in major abdominal oncological surgery. Thirty patie nts received 2 x 3,825 anti-Xa international units of CY 216 subcutane ously on the day of surgery followed by a single daily 3,825 anti-Xa i nternational units injection for 7 days; thirty-one patients did not r eceive any form of prophylaxis. The occurrence of deep vein thrombosis (DVT) was detected by I-125-labelled fibrinogen leg scan. Postoperati ve DVT developed in 2 patients in the CY 216 group and in 11 patients in the control group (6.8% vs 35.4%, p<0.01). Although there was a hig her postoperative transfusional requirement in the group receiving CY2 16 (p<0.05), the total number of patients transfused was similar in th e two groups (14 vs 13). On day 1 after surgery, the two patients who later developed DVT in the CT216 group had plasma anti-Xa activity sig nificantly lower (p<0.01) than the remaining patients. As a good relat ionship was found between plasma anti-Xa activity and body weight, ado ption of a personalized dosage schedule might improve efficacy of CY 2 16 prophylaxis.