Continuous intravenous infusion of a low-molecular-weight heparin during allogenic haematopoietic stem-cell transplantation.

Boeras, Anca;Lambert, Catherine;Ferrant, Augustin;Van Den Neste, Eric;Hermans, Cédric
(2008) Blood Coagulation and Fibrinolysis — Vol. 19, n° 7, p. 735-737 (2008)

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Low-molecular-weight heparins are routinely administered once or twice daily by subcutaneous injection. With the exception of patients on haemodialysis or presenting with unstable angina or flat Q-wave myocardial infarction, in which short-term intravascular administration is recommended, little information is available regarding the efficacy of continuous intravenous administration of low-molecular-weight heparins. We report the case of a 50-year-old patient who underwent an allogenic haematopoietic stem-cell transplantation for acute myeloid leukaemia. Prior to transplantation, the patient was on long-term oral anticoagulant (acenocoumarol) following the placement of a mechanical aortic valve. Acenocoumarol was stopped and low-molecular-weight heparin (nadroparin calcium) was administered intravenously through a continuous infusion pump (30 000 anti-Xa U/day) starting from day 0 until day 23 after transplantation. The patient was prophylactically transfused with platelets when the daily platelet count fell below 50 x 10 l. Repeated blood measurements showed that a therapeutic level of anti-Xa activity was achieved and maintained at a fairly constant level. No haemorrhagic or thrombotic complications occurred. This observation suggests that intravenous continuous infusion of low-molecular-weight heparin may be an alternative to subcutaneous injections in selected patients who need anticoagulation.
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Boeras, A., Lambert, C., Ferrant, A., Van Den Neste, E., & Hermans, C. (2008). Continuous intravenous infusion of a low-molecular-weight heparin during allogenic haematopoietic stem-cell transplantation. Blood Coagulation and Fibrinolysis, 19(7), 735-737. https://doi.org/10.1097/MBC.0b013e32830b14de (Original work published 2008)