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Sixty-eight patients suffering from breast cancer, ovarian cancer, lymphoma or multiple myeloma were treated with high-dose chemotherapy and autologous stem cell transplantation. They underwent placement of a central venous port via the subclavian vein for delivery of chemotherapy and reinfusion of stem cells. All patients were followed prospectively for device-related and overall complications, comprising a total of 18,213 days in situ (median: 267 days, range: 90-480). One patient experienced a pneumothorax (1.4%) spontaneously resolved, as an acute toxicity. Two patients (2.8%, 0.1 episodes/1000 days of use) were forced to have the port removed due to infection, caused by Streptococcus mitis in one case, while the causative agent was not identified by laboratory tests in the second. The other 66 patients completed the therapeutic programme, including peripheral stem cell reinfusions and supportive care, such as i.v. antibiotics, antiemetics or fluid administration and blood sample collection, without additional complications. In conclusion, the use of totally implantable central venous access ports has resulted in good long-term access to central veins, in spite of the severe neutropenia and increased septic risk of this category of oncology patients.

8020 Background: Disorders of coagulation are encountered in up to 90% of cancer patients (pts), although only 15% of them develop a localized acute or chronic deep venous thrombosis (DVT) or a dis...

To the Editor.— Intraoperative auto-transfusion, namely, the technique of blood aspiration from the surgical field and intravenous reinfusion of washed red blood cells, is employed in elective and emergency surgery with increasing frequency.1 We used this technique to recover red blood cells trapped in the spleen of three patients (Table) in whom splenectomy had to be performed because of severe anemia associated with considerable splenomegaly. Patients 1 and 2, suffering from thalassemia, had potent irregular red blood cell alloantibodies in the serum, which made transfusion of compatible blood extremely difficult; patient 3 had myelofibrosis.Methods.— The procedure was performed as follows. Splenectomy was carried out with careful dissection of the vascular structures. The spleen was then placed on a sterile table, weighed, and perfused through the arterial stump with heparinized saline (30 × 103 U/L). Perfusion was performed at a constant pressure of 150 mm Hg by means of