[Bilateral stenosis of the innominate veins in oncological patient]. / Stenosi bilaterale delle vene anonime in paziente oncologico.

Oncologic diseases frequently need a central venous catheterization to improve pharmacological administration safety and patient's comfort. We report a case of a woman affected by acute myelocytic leukemia with a bilateral stenosis of the innominate veins, likely of thrombotic nature, diagnosed during central venous catheterization. These events, as that occurred to our patient, are usually caused by hypercoagulability inducted by oncologic diseases, sepsis, antithrombin III deficiency, catheters materials and repeated catheterizations. Although the treatment, based on local thrombolysis, systemic heparinization, and surgery to repair venous obstruction, is effective, the prevention of such events is fundamental. It can be achieved with catheters of particular characteristics and appropriate management techniques. Finally it is underlined that in oncology patients, before catheterization, especially when the objective examination is negative, radiological methodologies and in particular ultrasonography are an important aid to establish the presence or absence of thrombosis in internal jugular, subclavian and innominate veins.

Enrichment of marrow hemopoietic progenitor cells using a blood cell processor.

A total of 93 bone marrows (BM) from normal donors and patients were processed using the IBM-COBE 2991 blood cell washer to produce a concentrated buffy coat (BC) for either bone marrow transplantation (BMT) or cryopreservation for subsequent autologous BMT. The reduction in volume was 73.3 +/- 8.5% and nucleated blood cells (NBC) recovery was 87.1 +/- 9.1% of original marrow. Red blood cell (RBC) and platelet (PLT) contamination was reduced 64.5 +/- 10.9% and 41.2 +/- 24.1%, respectively. Clonogenic activity indicated that the NBC fraction was highly enriched in hematopoietic progenitor cells (greater than 100%) as assessed in vitro (CFU-GM). Results were not affected by diagnosis, initial marrow volume or cell count of the BM suspension. We conclude that this is a simple and reproducible method using blood bank, facilities and permits BC preparation from BM without significant loss of hematopoietic progenitor cells.