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LONG TERM VENOUS ACCESS IN PATIENTS WITH ACUTE LEUKEMIA AND HIGH GRADE LYMPHOMAS (Based on AFMRC Project 1868/91).
Rajat Kumar1, R Ranga Rao2, G Rajagopal3
1Reader in Medicine, Armed Forces Medical College, Pune.
Medical Journal, Armed Forces India
|August 4, 2017
Summary
Hickman catheters provided effective venous access for chemotherapy patients with leukemia and lymphoma. Despite minor complications, these central venous catheters ensured safe treatment delivery in high-risk individuals.
Area of Science:
- Oncology
- Vascular Access Devices
- Hematology
Background:
- Chemotherapy for acute leukemia and high-grade lymphoma requires reliable venous access.
- Repeated venipuncture poses risks and discomfort for patients undergoing long-term treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of Hickman catheters for central venous access in patients receiving chemotherapy.
- To assess complication rates and management strategies associated with Hickman catheter use.
Main Methods:
- Twenty Hickman catheters were inserted into the superior vena cava in 19 patients (15 acute leukemia, 4 high-grade lymphoma).
- Catheters were tunneled subcutaneously with an exit site on the anterior chest wall.
- Functional effectiveness, duration of use, and complications were recorded.
Main Results:
- Hickman catheters were functionally effective in all 19 patients.
- The mean indwelling time was 50.5 days (range 1-266 days).
- Complications included hemorrhage (1), thrombosis (1), catheter-related bacteremia (2), tunnel infection (1), and exit site infection (5), mostly managed conservatively.
Conclusions:
- Hickman catheters offer a safe and reliable solution for venous access in high-risk cancer patients.
- These devices are well-tolerated and minimize the need for repeated venipuncture during chemotherapy.
- Effective management of complications ensures continued safe use in neutropenic, septic, or thrombocytopenic patients.
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