LONG TERM VENOUS ACCESS IN PATIENTS WITH ACUTE LEUKEMIA AND HIGH GRADE LYMPHOMAS (Based on AFMRC Project 1868/91)

Twenty Hickman catheters were passed in 19 patients undergoing chemotherapy for acute leukemia (15 patients) and high grade lymphoma (4 patients). The catheters were inserted into the superior vena cava through the cephalic or external jugular vein with subcutaneous tunneling and exit through the anterior chest wall, and were functionally effective in 19 cases. The catheters remained in situ for a mean period of 50.5 days (range 1-266 days). The catheters were well tolerated eliminating the need for repeated venepuncture. The complications encountered were: hemorrhage - 1 case, thrombosis - 1 case, catheter related bacteremia - 2 cases, tunnel infection - 1 case, and exit site infection - 5 cases. Most of the complications were managed conservatively. These catheters ensured safe and reliable venous access in these high risk patients during episodes of severe neutropenia, sepsis and thrombocytopenia.