Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2

Michael E. Eastman, Masoud Khorsand, Dennis G. Maki, Eliot C. Williams, Kyungmann Kim, Paul M. Sondel, Joan H. Schiller, Mark R. Albertini

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

BACKGROUND. This study was performed to determine the incidence of central venous device-related blood stream infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2 (IL-2). METHODS. The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous-infusion IL-2 (IL-2 [1.5-3.0 × 106 U/m2/day] Hoffman-LaRoche, Nutley, NJ or IL-2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL-2 therapy; 89% of these were cuffed Hickman catheters. Eighty-four patients received 1 mg of warfarin per day as prophylaxis against device-related thrombosis; none received periinsertion prophylactic antibiotics. RESULTS. Twenty-one patients (13%) developed central venous device-related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device-days. DRBSIs were associated with the type of immunotherapy given with IL-2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5-11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty-six patients (16%) developed central venous device-related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device-related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy. CONCLUSIONS. Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous-infusion IL-2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL-2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL-2. Low dose warfarin did not prevent DRT when started after device placement.

Original languageEnglish (US)
Pages (from-to)806-814
Number of pages9
JournalCancer
Volume91
Issue number4
DOIs
StatePublished - Feb 15 2001

Fingerprint

Interleukin-2
Thrombosis
Equipment and Supplies
Infection
Warfarin
Immunotherapy
Renal Cell Carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2. / Eastman, Michael E.; Khorsand, Masoud; Maki, Dennis G.; Williams, Eliot C.; Kim, Kyungmann; Sondel, Paul M.; Schiller, Joan H.; Albertini, Mark R.

In: Cancer, Vol. 91, No. 4, 15.02.2001, p. 806-814.

Research output: Contribution to journalArticle

Eastman, ME, Khorsand, M, Maki, DG, Williams, EC, Kim, K, Sondel, PM, Schiller, JH & Albertini, MR 2001, 'Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2', Cancer, vol. 91, no. 4, pp. 806-814. https://doi.org/10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K
Eastman, Michael E. ; Khorsand, Masoud ; Maki, Dennis G. ; Williams, Eliot C. ; Kim, Kyungmann ; Sondel, Paul M. ; Schiller, Joan H. ; Albertini, Mark R. / Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2. In: Cancer. 2001 ; Vol. 91, No. 4. pp. 806-814.
@article{8dd6921ba126404aaf4ed1d7e94d880e,
title = "Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2",
abstract = "BACKGROUND. This study was performed to determine the incidence of central venous device-related blood stream infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2 (IL-2). METHODS. The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous-infusion IL-2 (IL-2 [1.5-3.0 × 106 U/m2/day] Hoffman-LaRoche, Nutley, NJ or IL-2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL-2 therapy; 89{\%} of these were cuffed Hickman catheters. Eighty-four patients received 1 mg of warfarin per day as prophylaxis against device-related thrombosis; none received periinsertion prophylactic antibiotics. RESULTS. Twenty-one patients (13{\%}) developed central venous device-related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device-days. DRBSIs were associated with the type of immunotherapy given with IL-2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95{\%} confidence interval, 1.5-11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty-six patients (16{\%}) developed central venous device-related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device-related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy. CONCLUSIONS. Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous-infusion IL-2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL-2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL-2. Low dose warfarin did not prevent DRT when started after device placement.",
author = "Eastman, {Michael E.} and Masoud Khorsand and Maki, {Dennis G.} and Williams, {Eliot C.} and Kyungmann Kim and Sondel, {Paul M.} and Schiller, {Joan H.} and Albertini, {Mark R.}",
year = "2001",
month = "2",
day = "15",
doi = "10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K",
language = "English (US)",
volume = "91",
pages = "806--814",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2

AU - Eastman, Michael E.

AU - Khorsand, Masoud

AU - Maki, Dennis G.

AU - Williams, Eliot C.

AU - Kim, Kyungmann

AU - Sondel, Paul M.

AU - Schiller, Joan H.

AU - Albertini, Mark R.

PY - 2001/2/15

Y1 - 2001/2/15

N2 - BACKGROUND. This study was performed to determine the incidence of central venous device-related blood stream infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2 (IL-2). METHODS. The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous-infusion IL-2 (IL-2 [1.5-3.0 × 106 U/m2/day] Hoffman-LaRoche, Nutley, NJ or IL-2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL-2 therapy; 89% of these were cuffed Hickman catheters. Eighty-four patients received 1 mg of warfarin per day as prophylaxis against device-related thrombosis; none received periinsertion prophylactic antibiotics. RESULTS. Twenty-one patients (13%) developed central venous device-related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device-days. DRBSIs were associated with the type of immunotherapy given with IL-2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5-11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty-six patients (16%) developed central venous device-related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device-related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy. CONCLUSIONS. Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous-infusion IL-2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL-2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL-2. Low dose warfarin did not prevent DRT when started after device placement.

AB - BACKGROUND. This study was performed to determine the incidence of central venous device-related blood stream infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2 (IL-2). METHODS. The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous-infusion IL-2 (IL-2 [1.5-3.0 × 106 U/m2/day] Hoffman-LaRoche, Nutley, NJ or IL-2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL-2 therapy; 89% of these were cuffed Hickman catheters. Eighty-four patients received 1 mg of warfarin per day as prophylaxis against device-related thrombosis; none received periinsertion prophylactic antibiotics. RESULTS. Twenty-one patients (13%) developed central venous device-related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device-days. DRBSIs were associated with the type of immunotherapy given with IL-2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5-11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty-six patients (16%) developed central venous device-related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device-related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy. CONCLUSIONS. Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous-infusion IL-2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL-2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL-2. Low dose warfarin did not prevent DRT when started after device placement.

UR - http://www.scopus.com/inward/record.url?scp=0035864991&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035864991&partnerID=8YFLogxK

U2 - 10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K

DO - 10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K

M3 - Article

VL - 91

SP - 806

EP - 814

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -