Haematologica 2004;89: supplement no. 8 - Supplements ...

138Postersinternal jugular vein thrombosis showed by a CT scanof the thorax. PMBL diagnosis was made with mediastinoscopy,and radiologic control after four weeksof VACOP-B chemotherapy showed regression ofmediastinal mass and thrombosis, in the absence ofanticoagulation. The third patient was a 22-yearsoldwoman who experienced a clinically evidentjugular vein thrombosis 6 months before the radiologicevidence of an anterior mediastinal mass (PMBLdiagnosis was made by mediastinoscopy).The mediastinalmass together with thrombosis disappearedafter weekly chemotherapy, in the absence of anticoagulation.Conclusions: The high incidence of themediastinic venous thrombotic complication ofPMBL patients and its heavy clinical impact, deservesa retrospective analysis of a more consistent numberof cases. Maybe a search for plasmatic tumoralthrombogenic substances could be useful in newpatients, to correctly assess the risk in each patient.PO-086PREVALENCE OF THROMBOEMBOLIC EVENTS ANDTHROMBOPHILIAS IN PATIENTS WITH ACUTE LEUKEMIAGrandone E, Melillo L, Colaizzo D, Cappucci F,Chinni E, Margaglione MIRCCS Casa Sollievo della Sofferenza, S. GiovanniRotondo, and Medical Genetics, University of Foggia,ItalyThrombotic events (TE) are poorly investigatedcomplications of adults with acute leukemia (AL).Aim of this study was to determine the prevalence ofTE and to detect any association of TE with the presenceof congenital or acquired prothrombotic factorsin patients affected by AL. From December 1999 toJune 2003 we evaluated the prevalence of geneticand acquired risk factors of thrombosis in a consecutiveseries of 72 adult patients with AL at diagnosis.Thirty-one patients had acute lymphoblasticleukemia (ALL) and 41 acute myeloblastic leukemia(AML) ( AML-M3 in 9 cases). Median age was 39years (range 16- 62). They were treated accordingto the established GIMEMA protocols. No patientsreceived heparin or any other anticoagulants. FactorV G1691A mutation (FV-L), prothrombin G200210A(FII20210) gene variant, MTHFR C677T variant, proteinC, protein S and antithrombin (AT) deficiencyand the presence of Lupus Anticoagulant (LA) andanticardiolipin antibodies (aCL) were evaluated. FV-L was observed in 1 patient (1.4%), FIIA20210 mutationin 2 patients (2.8%) and MTHFR C677T variantin 12 (16.6%) patients. The prevalence of thesemutations was not statistically different from thatobserved in the general population from the sameethnic background. Twenty-six (36.1%) patients hadhyperhomocysteinemia (>95% above reference values),partially related to the presence of TT MTHFRhomozygosity. As far as natural anticoagulants areconcerned, 6 patients (9.5%) showed low levels ofprotein S, while no patient showed protein C or ATdeficiency. Low titer of aCL was found in 2 (3.1%)cases. Six patients (8.3%) ( 2 ALL, 2 AML and 2 AML-M3) developed TE, 5 out of them in the first monthof follow up. Two out of six patients ( 33.3%) showedthe association of FV-L or FIIA20210 mutations andhyperhomocysteinemia. The OR for TE in patientswith double defects was 11.0 (95%CI 1.4-85.8, Fisherexact test, p= 0.048). The prevalence of TE isexceedingly high in adults with AL. Patients withdouble thrombophilic defects appear to be at highrisk for the development of early TE.PO-087CENTRAL VENOUS CATHETER RELATED THROMBOSIS INPATIENTS WITH HEMATOLOGIC MALIGNANCIES WITHOUTPHARMACOLOGICAL PROPHYLAXIS: RETROSPECTIVEANALYSISSilingardi M, Bonini A,* Galimberti D, D’incà M,Nicolini A, Negri EA, Casali A, Trenti C, Iotti M,Gugliotta L,* Iori IU.O Medicina I^, Centro Emostasi e Trombosi, *U.O.Ematologia, Az. Ospedaliera S. Maria Nuova, ReggioEmilia, ItalyThe reported incidence of symptomatic centralvenous catheter (CVC) related deep venous thrombosis(DVT) in adult cancer patients varies from 0.3to 28.3% in different series. The issue of antithromboticprophylaxis in these patients is still a matter ofdebate. These data are obtained mainly from nonhematologicalsolid cancers. Few data are availablefor haematological patients. We retrospectively analyzedthe clinical records of 128 consecutive patientswith haematological malignancies. Between January1998 and December 2003, 218 CVCs wereimplanted in 128 patients (56 females, 72 males:mean age 47, range 15-70) consecutively admittedto the Haematology Unit for acute lymphoblasticleukemia (8 ), acute myeloid leukemia (32), Hodgkin’slymphoma ( 14), non- Hodgkin’s lymphoma (29),multiple myeloma (34), myelodiplastic syndrome (1),primary amyloidosis (1), severe neutropenia (1). AllCVCs were centrally inserted under aseptic conditions.No pharmacological prophylaxis was administered,according to our Institution’s policy. Symptomaticcatheter related deep venous thrombosis (DVT)was recorded. Superficial thrombophlebitis was notconsidered. The median duration of the CVCs was 29days for a total of 6322 catheter/days. Seven symptomaticepisodes of catheter-related upper extrem-haematologica vol. 89(suppl. n. 8):september 2004