对于恶性淋巴瘤患者,中心静脉(CV)导管相关性颈内静脉血栓形成的抗凝治疗的选择和适当的治疗持续时间仍不清楚。R-CHOP治疗2例侵袭性B细胞淋巴瘤(利妥昔单抗,环磷酰胺,阿霉素,长春新碱,和泼尼松龙),其中阿哌沙班给药少于3个月对CV导管相关性颈内静脉血栓形成有效,已报告。在一个案例中,右颈内静脉血栓形成在8个疗程的R-CHOP后;当阿哌沙班口服治疗37天后,血栓完全溶解,27个月内未复发.在另一种情况下,4个疗程的R-CHOP治疗后出现右颈内静脉血栓形成;另外2个疗程的R-CHOP治疗与不拔除导管的口服阿哌沙班治疗同时进行.口服阿哌沙班66天后,血栓完全溶解,移除CV导管,8.5个月无复发。
The selection of anticoagulant therapy and appropriate duration of treatment for central venous (CV) catheter-associated internal jugular vein thrombosis in patients with malignant lymphoma remain unclear. Two cases of aggressive B-cell lymphomas treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), in which apixaban administered for less than three months was effective against CV catheter-associated internal jugular vein thrombosis, are reported. In one case, the right internal jugular vein thrombosis developed after eight courses of R-CHOP; when apixaban was orally administered for 37 days after the CV catheter was removed, the thrombus completely dissolved and did not recur for 27 months. In the other case, right internal jugular vein thrombosis developed after four courses of R-CHOP; two additional courses of the R-CHOP were administered alongside oral apixaban administration without catheter removal. After 66 days of oral apixaban, the thrombus completely dissolved, the CV catheter was removed, and no recurrence was observed for 8.5 months.